From: Cerebrovascular disease associated with antiphospholipid antibodies: more questions than answers
Demographics | Patients fulfilling Sapporo classification criteria | Group with transiently positive aCL | Group with low positive aCL |
---|---|---|---|
Number of patients | N = 26 | N = 7 | N = 12 |
Median age (years) | 37.6 (6–63) | 35.4 (16–51) | 41.6 (19–59) |
Number of episodes/patient | Â | Â | Â |
1 | 19 | 4 | 6 |
2 | 7 | 3 | 6 |
Clinical presentations | N = 33 | N = 10 | N = 18 |
Superior sagittal sinus thrombosis | 1 | 1 | - |
Higher centre function loss | 3 | 1 | 1 |
Left hemiparesis/paraesthesia | 10 | 5 | 6 |
Right hemiparesis/paraesthesia | 6 | - | 2 |
Brainstem/cerebellar symptoms | 5 | - | 5 |
Loss of consciousness/seizures | 4 | - | 1 |
Fluent aphasia, right facial weakness | 1 | - | - |
Bilateral cerebral infarction | - | 1 | - |
Cranial nerve palsies | 1 | 2 | 1 |
Right homonymous hemianopia | 1 | - | 1 |
Transient ischaemic attacks | 1 | - | 1 |
Radiological findings | N = 26 | N = 7 | N = 12 |
No abnormalities on CT or MRI scan | 2 | 3 | 6 |
Left middle/posterior cerebral artery territory infarction | 4 | - | 2 |
Right middle/posterior cerebral artery territory infarction | 4 | - | - |
Low density area (left temporal lobe) | 2 | - | - |
Increased signal cerebral deep white matter | 3 | 1 | 2 |
Pontine/cerebellar infarction | 2 | 1 | 1 |
Multiple cerebral infarcts | 9 | - | 1 |
Superior sagittal sinus thrombosis | - | 1 | - |
Bilateral narrowing of carotid syphons | - | 1 | - |
Antiphospholipid studies: | Â | Â | Â |
IgM aCL | 6 moderate -high positive | - | 3 low positive |
IgG aCL | 18 moderate -high positive | 1 low positive, 1 moderate positive | 6 low positive, 3 moderate positive |
Lupus anticoagulant KCT | 9 | 4 | 2 |
Lupus anticoagulant DRVVT | 9 | 6 | 2 |
Low to moderate IgG anti-β2GP1antibodies | 7/12 (data incomplete) | 1 low positive | 1 low positive |
Risk factors for vascular disease | Â | Â | Â |
Hypercholesterolaemia | 3 | - | 4 |
Hypertension | 4 | 1 | 3 |
Tobacco use | 3 | 2 | 3 |
Oral contraceptive pill/hormone replacement therapy | 6 | - | 1 |
Pregnancy/post-partum period | 2 | 1 | - |
Heterozygosity for factor V Leiden mutation | Â | 1 | - |
Long term warfarin | 19 | 2 | - |
Warfarin (six months) | - | 1 | 1 |
Low dose aspirin | 6 | 4 | 10 |
Clopidogrel/ticlopidine | 1 | - | 1 |