[Antiphospholipid antibodies and neurological disorders. Types and mechanisms]

The antiphospholipid antibodies (AAFL) are acquired antibodies of different types whose common characteristic is that they are directed against the negatively and neutrally charged phospholipids of the cell membranes. They were first described in 1952 in patients with systemic lupus erythematosus. They are also found in many pathological conditions such as: infections, solid and haematological neoplasms, chronic renal insufficiency, primary immunological deficiencies and other collagenoses, hepatobiliary diseases, etc. They are also found in other circumstances: due to the use of various drugs (which in general may induce lupus), in elderly patients and in apparently healthy people. The great interest shown in the past decade, as a result of their association with and possible etiopathogenic role in a series of thrombotic phenomena, neuropsychiatric disorders, thrombocytopenia and abortion-fetal death, has made them a major challenge to the clinician. This interest is increased by the controversial and very doubtful relationship that may exist with a series of disorders which have been described in detail. Their role as a probable risk factor for thrombosis in the general population is also discussed. For these reasons, we decided to review the basic biology of the AAFL and the aspects related to neurological disorders.