Korean Journal of Radiology

  • 제1권1호
  • /
  • Pages.5-10
  • /
  • 2000
  • /
  • 1229-6929(pISSN)
  • /
  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지

Primary Antiphospholipid Antibody Syndrome: Neuroradiologic Findings in 11 Patients

  • Jung Hoon Kim (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choong-Gon Choi (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Soo-Jung Choi (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ho Kyu Lee (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Dae Chul Suh (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 1999.10.13
  • 심사 : 2000.02.09
  • 발행 : 2000.03.31
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초록

Objective: To describe the neuroradiologic findings of primary antiphospholipid antibody syndrome (PAPS). Materials and Methods: During a recent two-year period, abnormally elevated antiphospholipid antibodies were detected in a total of 751 patients. In any cases in which risk factors for stroke were detected - hypertension, diabetes mellitus, hyperlipidemia, smoking, and the presence of SLE or other connective tissue diseases - PAPS was not diagnosed. Neuroradiologic studies were performed in 11 of 32 patients with PAPS. We retrospectively reviewed brain CT (n = 7), MR (n = 8), and cerebral angiography (n = 8) in 11 patients with special attention to the presence of brain parenchymal lesions and cerebral arterial or venous abnormalities. Results: CT or MR findings of PAPS included nonspecific multiple hyper-intensity foci in deep white matter on T2-weighted images (5/11), a large infarct in the territory of the middle cerebral artery (4/11), diffuse cortical atrophy (2/11), focal hemorrhage (2/11), and dural sinus thrombosis (1/11). Angiographic findings were normal (5/8) or reflected either occlusion of a large cerebral artery (2/8) or dural sinus thrombosis (1/8). Conclusion: Neuroradiologic findings of PAPS are nonspecific but in young or middle- aged adults who show the above mentioned CT or MR findings, and in whom risk factors for stroke are not present, the condition should be suspected.

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참고문헌

  1. Harris EN, Gharavi AE, Hughes GRV. Antiphospholipid antibodies. Clin Rheum Dis 1985;11:591-609  https://doi.org/10.1016/S0307-742X(21)00606-8
  2. Harris EN, Baguley E, Asherson RA, et al. Clinical and serological features of the antiphospholipid syndrome . Br J Rheumatol 1987;26(S):19 
  3. Hughson MD, Mccarty GA, Brumback RA. Spectrum of vascular pathology affecting patients with the antiphospholipid syndrome. Hum Pathol 1995;26:716-724  https://doi.org/10.1016/0046-8177(95)90218-X
  4. Asherson RA, Khamashta MA, Ordi-Ros J, et al. The primary antiphospholiupid syndrome: major clinical and serological features. Medicine 1989;68:366-374  https://doi.org/10.1097/00005792-198911000-00004
  5. Gharavi AE, Wilson WA. The syndrome of thrombosis, thrombocytopenia, and recurrent spontaneous abortions associated with antiphospholipid antibodies: Hughes syndrome. Lupus 1996;5:343-344  https://doi.org/10.1177/096120339600500501
  6. Provenzale JM, Heinz ER, Ortel TL, et al. Antiphospholipid antibodies in patients without SLE: neuroradiologic findings. Radiology 1994;192:531-537  https://doi.org/10.1148/radiology.192.2.8029427
  7. Provenzale JM, Barboriak DP, Allen NB, Ortel TL. Patients with antiphospholipd antibodies: CT and MR findings of the brain. AJR 1996;167:1573-1578  https://doi.org/10.2214/ajr.167.6.8956600
  8. Toubi E, Khamashta MA, Panarra A, Hugham GRV. Association of antiphospholipid antibodies with central nervous system disease in SLE. Am J Med 1995;99:397-401  https://doi.org/10.1016/S0002-9343(99)80188-0
  9. Brey RL, Gharavi AE, Lockshin MD. Neurologic complications of antiphospholipid antibodies. Rheumatol Clin North Am 1993;4:833-850  https://doi.org/10.1016/S0889-857X(21)00209-X
  10. Oeffinger KC, Roaten SP. Antihpospholipid syndrome. J Fam Prac 1994;38:611-619 
  11. Petri M. Pathogenesis and treatment of the antiphospholipid antibody syndrome. Med Clin North Am 1997;81:151-177  https://doi.org/10.1016/S0025-7125(05)70509-5
  12. Aron AL, Gharavi AE, Shoenfeld Y. Mechanisms of action of antiphospholipid antibodies in the antiphospholipid antibodies in the antiphospholipd syndrome. Int Arch Allergy Immunol 1995;106:8-12  https://doi.org/10.1159/000236883
  13. Lechner K, Pabinger-Fasching I. Lupus anticoagulants and thrombosis: a study of 25 cases and review of the literature. Haemostasis 1985;15:254-262  https://doi.org/10.1159/000215157
  14. Levine SR, Brey RL. Neurological aspects of antihpospholipid antibody syndrome. Lupus 1996;5:347-353  https://doi.org/10.1177/096120339600500503
  15. Westerman EM, Miles JM. Neuropathologic findings in multi-infarct dementia associated with anticardiolipin antibody. Arthritis Rheum 1992;35:1038-1041  https://doi.org/10.1002/art.1780350908
  16. Coull BM, Bourdette DN, Goodnight SH, Briley DP, Hart R. Multiple cerebral infarctions and dementia as associated with anticardiolipin antibodies. Stroke 1987;18:1107-1112  https://doi.org/10.1161/01.STR.18.6.1107
  17. Westerman EM, Miles KM, Backonja M, Sundstrom WR. Neuropahtologic findings in multi-infarct dementia associated with anticardiolipin antibody. Arthritis Rheum 1992;9:1038-1041  https://doi.org/10.1002/art.1780350908
  18. Levin SR, Kieran S, Puzio K, et al. Cerebral venous thrombosis with lupus anticoagulants: report of two cases. Stroke 1987;18:801-804  https://doi.org/10.1161/01.STR.18.4.801
  19. Carhuapoma JR, Mitsias P, Levine SR. Cerebral venous thrombosis and antiphospholipid antibodies. Stroke 1997;28:2363-2369 https://doi.org/10.1161/01.STR.28.12.2363