We report a case with epileptic seizures, cognitive dysfunction, livedo reticularis, renal microangiopathy, acute myocardial infarction and high titres of anticentromere antibodies (ACA) and IgG/IgM anticardiolipin antibodies. This is a rare association between primary antiphospholipid syndrome and ACA positivity that has not been reported so far in the literature.
Wilson WA , Gharavi AE , Koike Tet al.International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an internatiomal workshop . Arthritis Rheum1999; 42: 1309-1311 .
2.
Sanna G , Bertolaccini ML , Cuadrado MJ , Khamashta MA , Hughes GR.Central nervous system involvement in the antiphospholipid (Hughes) syndrome . Lupus2003; 42: 200-213 .
3.
Shoenfeld Y , Lev S , Blatt Iet al.Features associated with epilepsy in the antiphospholipid syndrome . J Rheumatol2004; 31: 1344-1348 .
4.
Mackworth-Young CG , Hughes GR.Epilepsy: an early symptom of systemic lupus erythematosus . J Neurol Neurosurg Psychiatry1985; 48: 185-185 .
5.
Cervera R , Piette JC , Font Jet al.Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1000 patients . Arthritis Rheum2002; 46: 1019-1027 .
Hachulla E , Michon-Pasturel U , Leys Det al.Cerebral magnetic resonance imaging in patients with or without antiphospholipid antibodies . Lupus1998; 7: 124-131 .
8.
Nochy D , Daugas E , Droz Det al.The intrarenal vascular lesions associated with primary antiphospholipid syndrome . J Am Soc Nephrol1999; 10: 507-518 .
Trostle DC , Bedetti CD , Steen VD , Al-Sabbagh MR , Zee B , Medsger TA Jr.Renal vascular histology and morphometry in systemic sclerosis. A case-control autopsy study . Arthritis Rheum1988; 31: 393-400 .
11.
Molina JF , Anaya JM , Cabrera GEet al.Systemic sclerosis sine scleroderma: an unusual presentation in scleroderma crisis . J Rheumatol1995; 22: 557-560 .
12.
Mitri GM , Lucas M , Fertig N , Steen VG , Medsger TA Jr.A comparison between anti-Th/To- and anticentromere antibody-positive systemic sclerosis patients with limited cutaneous involement . Arthritis Rheum2003; 48: 203-209 .
13.
Heron E , Fornes P , Rance A , Emmerich J , Bayle O , Fiessinger JN.Brain involvementinscleroderma:twoautopsy cases . Stroke1998; 29: 719-721 .
14.
Powell FC , Winkelmann RK , Venencie-Lemarchand F , Spurbeck JL , Schroeter AL.The anticentromere antibody: disease specificity and clinical significance . Mayo Clin Proc1984; 10: 700-706 .
15.
Tektonidou M , Kaskani E , Skopouli FN , Moutsopoulos HM.Microvascular bnormalities in Sjogren’s syndrome: nailfold capillaroscopy . Rheumatology (Oxford). 1999; 9: 826-830 .
16.
Wigley FM , Wise RA , Miller R , Needleman BW , Spence RJ.Anticentromere antibody as a predictor of digital ischemic loss in patients with systemic sclerosis . Arthritis Rheum1992; 35: 688-693 .
17.
Buchanan RR , Riglar AG.The titre of anti-centromere antibodies: its relationship to Raynaud’s phenomenon and vascular occlusion . Br J Rheumatol1989; 28: 221-226 .
18.
Picillo U , Migliaresi S , Marcialis MR , Ferruzzi AM , Tirri G.Clinical setting of patients with systemic sclerosis by serum autoantibodies . Clin Rheumatol1997; 16: 378-383 .
19.
Picillo U , Migliaresi S , Marcialis MR , Ferruzzi AM , Tirri G.Clinical significance of anticardiolipin antibodies in patients with systemic sclerosis . Autoimmunity1995; 20: 1-7 .
20.
Pope JE , Thomson A.The frequency and significance of anticardiolipin antibodies in scleroderma . J Rheumatol2000; 27: 1450-1452 .