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Spinal cord infarction associated with primary antiphospholipid syndrome in a young child. Case report
M Hasegawa1, J Yamashita, T Yamashima
1Department of Neurosurgery, Kanazawa University School of Medicine, Japan.
Insights
Antiphospholipid antibodies may cause spinal cord infarction. This case report highlights primary antiphospholipid syndrome as a potential cause of spinal cord ischemia in children, previously misdiagnosed as myelitis.
Area of Science:
- Neurology
- Immunology
- Vascular Medicine
Background:
- Antiphospholipid antibodies are linked to ischemic stroke.
- Spinal cord infarction etiology is often unclear, sometimes attributed to spontaneous events or myelitis.
Observation:
- A 6-year-old boy presented with spinal cord infarction.
- MRI revealed thoracolumbar spinal cord swelling and enhancement, progressing to atrophy.
- Serological tests confirmed lupus anticoagulant and immunoglobulin G anticardiolipin antibody positivity.
Findings:
- This case demonstrates a link between primary antiphospholipid syndrome and spinal cord infarction.
- The presence of antiphospholipid antibodies was confirmed in the patient.
Implications:
- Antiphospholipid antibodies should be considered in the differential diagnosis of spinal cord ischemia in pediatric patients.
- Recognizing antiphospholipid antibodies as an etiological factor may prevent misdiagnosis of spinal cord infarction as myelitis or spontaneous events.
Abstract:
Antiphospholipid antibodies have been reported to occur in ischemic stroke patients, but there have been no previous reports linking these antibodies to spinal cord infarction. A case of spinal cord infarction associated with primary antiphospholipid syndrome in a 6-year-old boy is reported. Magnetic resonance imaging clearly demonstrated marked swelling of the thoracolumbar spinal cord with gadolinium-diethylenetriamine pentaacetic acid enhancement at an acute stage, followed later by cord atrophy. Serological study disclosed positive lupus anticoagulant and immunoglobulin G anticardiolipin antibody. It is suggested that the role of antiphospholipid antibodies as an etiological factor for spinal cord ischemia should be recognized among causes that might have been categorized as either spontaneous spinal cord infarction or myelitis.