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Letters   |    
Primary Antiphospholipid Syndrome Mimicking Demyelinating Disorders
Panagiotis Ioannidis, M.D., Ph.D.; Pantelis Maiovis, M.D.; George Balamoutsos, M.D; Dimitris Karacostas, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E54-E55. doi:10.1176/appi.neuropsych.13050109
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The authors report no financial relationships with commercial interests.

B’ Dept. of Neurology, AHEPA University Hospital Thessaloniki, Greece

Send correspondence to Dr. Ioannidis; e-mail: ioannidispanosgr@yahoo.gr

Copyright © 2014 by the American Psychiatric Association


To the Editor: Primary antiphospholipid syndrome (PAPS) is characterized by arterial or venous thrombosis, spontaneous abortions, and the persistent presence of antiphospholipid antibodies, namely the lupus anticoagulant (LA), the anticardiolipin (aCL), and antiβ2 glycoprotein I (antiβ2GPI) antibodies.1 PAPS is a rare and controversial disorder with multiple neurological complications that can mimic various diseases, delaying the final correct diagnosis.2

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FIGURE 1. Initial Magnetic Resonance Imaging (MRI): Few, Nonenhancing, White Matter Hyperintensities in the Brain (a, arrows), on Axial T2 Weighted Image (wi), Accompanied by an Ovoid Thoracic (Th5 – Th6) Spinal Cord, Nonenhancing Lesion, on Sagittal (b), and Axial Proton Density Sequence (c, arrow)

FIGURE 2. Recent MRI Study: Multiple White Matter Hyperintensities in the Brain, on Axial Fluid Attenuated Inversion Recovery (a) and T2wi (b) With Ring Enhancement on T1wi (c, arrow). This Time, a Midcervical (C5) Nonenhancing Lesion, was Found on Sagittal (d) and Axial T2wi (e, arrow).


Levine  JS;  Branch  DW;  Rauch  J:  The antiphospholipid syndrome.  N Engl J Med 2002; 346:752–763
[CrossRef] | [PubMed]
Ferreira  S;  D’Cruz  DP;  Hughes  GR:  Multiple sclerosis, neuropsychiatric lupus and antiphospholipid syndrome: where do we stand? Rheumatology (Oxford) 2005; 44:434–442
[CrossRef] | [PubMed]
Miyakis  S;  Lockshin  MD;  Atsumi  T  et al:  International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS).  J Thromb Haemost 2006; 4:295–306
[CrossRef] | [PubMed]
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