Title:Subtypes of Antiphospholipid Antibodies in Neurologic Disorders: An Observational Study
VOLUME: 15 ISSUE: 1
Author(s):Maryam Sahebari*, Maryam Rastin, Reza Boostani, Mohsen Forughipour, Kamila Hashemzadeh and Samira H. Sadeghi
Affiliation:Rheumatic Diseases Research Center, Mashhad, Immunology Research Center, Mashhad, Department of Neurology, Mashhad, Department of Neurology, Mashhad, Rheumatic Diseases Research Center, Mashhad, School of Medicine, Mashhad
Keywords:Antiphospholipid antibody, antiphospholipid syndrome, anti-β2Glycoprotein1, lupus, central nervous system, neurological
accident.
Abstract:Background and Objectives: Concomitant neurologic manifestations and positive antiphospholipid
antibodies (APAs) have been investigated in different manners. The present study
aimed to investigate the association between neurologic manifestations and APAs.
Materials and Methods: This cross-sectional descriptive study was conducted on 100 consecutive
patients with selected neurological manifestations and at least one positive APAs within the age
range of 20-50 years, referred to the Rheumatic Diseases Research Center from the Northeast Central
Neurology Department of Iran during August 2012 to March 2014.
Results: According to the results, 89% of the participants were persistently positive for APAs,
including lupus anticoagulant, IgG anticardiolipin (aCL), IgM aCL, IgG β-2 glycoprotein 1 (β2-
GP1), and IgM β2-GP1, observed in 16%, 41%, 42%, 17%, and 15% of the patients, respectively.
Furthermore, 10% of the patients had concomitant lupus manifestations, and 37% of them showed
anti-DNA. The IgG and IgM aCL were the most prevalent antibodies. Cerebral vascular accident
(33%), retinal artery/vein occlusion (21%), and seizure (20%) were the most frequent presentations
among the patients. In addition, the patients with multiple sclerosis (composing 3% of the subjects)
were 100% positive for IgG and IgM aCL, as well as lupus anticoagulant. In addition, IgM anti-β2-
GP1 was 100% positive in optic neuritis patients (composing 5% of the subjects) and was significantly
associated with this neurologic disorder. IgM anti-β2-GP1 was also prevalent in the cases
with Guillain-Barré syndrome. The most prevalent persistently positive antibody in the patients
with cerebrovascular accident was IgM aCL.
Conclusion: The findings of this study revealed some associations between the subtypes of APAs
and incidence of neurologic disorders. However, the exact correlation between those symptoms and
APAs needs further investigations.