Cerebrovascular and neurologic disease associated with antiphospholipid antibodies
Cerebrovascular and neurologic disease associated with antiphospholipid antibodies
复制标题
与抗磷脂抗体相关的脑血管和神经系统疾病
作者：
S. Levine;M. J. Deegan;N. Futrell;K. Welch
狼疮抗凝剂和抗心磷脂抗体是具有相关抗原特异性的抗磷脂抗体（APLAb），是新认识到的血栓形成风险增加的标志物。我们研究了48例与APLAb相关的脑或视觉功能障碍患者，以帮助阐明这些患者的诊断、临床、实验室、放射学和病理学特征。大多数患者表现为短暂性脑缺血或脑梗死。经常发生复发性和定型事件。一过性黑蒙、视网膜动脉或静脉阻塞、枕叶缺血、复视和偏头痛样障碍导致视力障碍。3例患者表现为严重的非典型偏头痛。脑和眼的复发性梗死与吸烟、高脂血症和抗核抗体阳性显著相关。在44.4患者年的前瞻性随访中，卒中和全身血栓事件的合并发生率为0.27例事件/患者年，如果包括TIA和死亡，则为0.54例事件/患者年。40例（83%）患者没有系统性红斑狼疮（SLE）。15例（31%）患者出现血小板减少，11例（23%）患者出现假阳性VDRL。脑血管造影正常或显示大血管闭塞或狭窄，无提示血管炎的变化。只有短暂性功能障碍的患者通常有正常的放射学检查，包括血管造影。器官和动脉血管的病理学研究显示血栓闭塞性疾病，无血管炎。APLAb与免疫介导的血栓形成倾向密切相关，通常在没有SLE的情况下。其他卒中风险因素可能增加APLAb患者缺血性事件复发的风险。
Lupus anticoagulants and anticardiolipin antibodies are antiphospholipid antibodies (APLAb) with related antigenic specificities and are newly recognized markers for an increased risk of thrombosis. We studied 48 patients who presented with cerebral or visual dysfunction associated with APLAb to help clarify the diagnostic, clinical, laboratory, radiologic, and pathologic features in these patients. Most patients presented with transient cerebral ischemia or cerebral infarction. Recurrent and stereotypic events were frequent. Visual disturbances resulted from amaurosis fugax, retinal arterial or venous occlusion, occipital ischemia, diplopia, and migraine-like disturbances. Three patients presented with severe atypical classic migraine. Recurrent infarcts of brain and eye were significantly associated with the presence of cigarette smoking, hyperlipidemia, and a positive antinuclear antibody. During 44.4 patient-years of prospective follow-up, the combined stroke and systemic thrombotic event rate was 0.27 events per patient-year and was 0.54 events per patient-year if TIA and death were included. Forty (83%) of the patients did not have systemic lupus erythematosus (SLE). Thrombocytopenia was present in 15 (31%) and a false-positive VDRL in 11 (23%) of the patients. Cerebral angiography was normal or revealed large-vessel occlusion or stenosis without changes suggestive of vasculitis. Patients with only transient dysfunction generally had normal radiologic studies, including angiography. Organs and arterial vessels studied pathologically revealed thrombotic occlusive disease without vasculitis. APLAb are strongly associated with an immune-mediated thrombotic tendency, generally in the absence of SLE. Other stroke risk factors may add to the risk of recurrent ischemic events in patients with APLAb.
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狼疮抗凝剂与抗磷脂酰丝氨酸抗体的关联。
DOI：
10.1016/0090-1229(87)90173-5
发表时间：
1987
期刊：
Clinical immunology and immunopathology
影响因子：
--
作者：
Branch,DW;Rote,NS;Dostal,DA;Scott,JR
通讯作者：
Scott,JR
多发性脑梗塞和痴呆与抗心磷脂抗体相关。
影响因子：
8.3
作者：
Coull,BM;Bourdette,DN;GoodnightJr,SH;Briley,DP;Hart,R
通讯作者：
Hart,R
影响因子：
20.3
作者：
P. Thiagarajan;V. Pengo;S. Shapiro
通讯作者：
P. Thiagarajan;V. Pengo;S. Shapiro
狼疮抗凝剂、抗心磷脂抗体和脑缺血。
影响因子：
8.3
作者：
Kushner,M;Simonian,N
通讯作者：
Simonian,N
与抗磷脂抗体相关的一系列神经系统疾病。
影响因子：
--
作者：
Levine,SR;Welch,KM
通讯作者：
Welch,KM