A case with epilepsy,cognitive impairment,renal microangiopathy and high titres of anticentromere and anticardiolipin antibodies

Abstract

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.

Keywords

anticentromere antibodies antiphospholipid syndrome cognitive dysfunction epilepsy renal microangiopathy

Get full access to this article

View all access options for this article.

References

Wilson WA , Gharavi AE , Koike T et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an internatiomal workshop . Arthritis Rheum 1999; 42: 1309-1311 .

Sanna G , Bertolaccini ML , Cuadrado MJ , Khamashta MA , Hughes GR. Central nervous system involvement in the antiphospholipid (Hughes) syndrome . Lupus 2003; 42: 200-213 .

Shoenfeld Y , Lev S , Blatt I et al. Features associated with epilepsy in the antiphospholipid syndrome . J Rheumatol 2004; 31: 1344-1348 .

Mackworth-Young CG , Hughes GR. Epilepsy: an early symptom of systemic lupus erythematosus . J Neurol Neurosurg Psychiatry 1985; 48: 185-185 .

Cervera R , Piette JC , Font J et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1000 patients . Arthritis Rheum 2002; 46: 1019-1027 .

Denburg SD , Carbotte RM , Denburg JA. Psychological aspects of systemic lupus erythematosus: cognitive function, mood, and self-report . J Rheumatol 1997; 24: 998-1003 .

Hachulla E , Michon-Pasturel U , Leys D et al. Cerebral magnetic resonance imaging in patients with or without antiphospholipid antibodies . Lupus 1998; 7: 124-131 .

Nochy D , Daugas E , Droz D et al. The intrarenal vascular lesions associated with primary antiphospholipid syndrome . J Am Soc Nephrol 1999; 10: 507-518 .

Vaughan C , Delanty N. Hypertensive emergencies . Lancet 2000; 356: 411-417 .

10.

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 Rheum 1988; 31: 393-400 .

11.

Molina JF , Anaya JM , Cabrera GE et al. Systemic sclerosis sine scleroderma: an unusual presentation in scleroderma crisis . J Rheumatol 1995; 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 Rheum 2003; 48: 203-209 .

13.

Heron E , Fornes P , Rance A , Emmerich J , Bayle O , Fiessinger JN. Brain involvementinscleroderma:twoautopsy cases . Stroke 1998; 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 Proc 1984; 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 Rheum 1992; 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 Rheumatol 1989; 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 Rheumatol 1997; 16: 378-383 .

19.

Picillo U , Migliaresi S , Marcialis MR , Ferruzzi AM , Tirri G. Clinical significance of anticardiolipin antibodies in patients with systemic sclerosis . Autoimmunity 1995; 20: 1-7 .

20.

Pope JE , Thomson A. The frequency and significance of anticardiolipin antibodies in scleroderma . J Rheumatol 2000; 27: 1450-1452 .