Pardo A, González-Porque P, Gobernado J M, Jiménez-Escrig A, Lousa M
Departments of Hematology, Hospital Ramón y Cajal, Madrid.
Neurologia. 2001 Jan;16(1):7-10.
Antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies) are associated with a variety of clinical situations, including drug-intake, but their relationships with antiepileptic drugs have been scarcely investigated.
To determine the prevalence of antiphospholipid antibodies in patients treated with antiepileptic drugs and the associated risk of thrombotic events.
We performed the serologic study of thirty-six consecutively prospectively recruited epileptic patients treated with diverse antiepileptic drugs during 44.38 +/- 8.08 months (mean +/- SD) in which antiphospholipid antibodies were determined using cardiolipin and a mixture of phospholipid from rabbit brain as antigen for detection of cardiolipin and lupus anticoagulant by ELISA and in addition lupus anticoagulant was carried out also using coagulometric assays. A clinical evaluation was done in order to determine the presence of thrombotic events in the following five years.
Antiphospholipid antibodies were detected in 43% of these patients, in most of them as anticardiolipin antibodies (IgM subtype). The patients did not present thrombotic events during the time of the study.
Antiphospholipid antibodies are positive in a high proportion of these patients but thrombosis were not found during the study duration. This may be explained by the fact that the profile of aCL positivity not associated to positive LA observed in these patients does not confer a risk for thrombotic events.
抗磷脂抗体（狼疮抗凝物和抗心磷脂抗体）与多种临床情况相关，包括药物摄入，但它们与抗癫痫药物的关系鲜有研究。
确定接受抗癫痫药物治疗的患者中抗磷脂抗体的患病率以及血栓形成事件的相关风险。
我们对36例连续前瞻性招募的癫痫患者进行了血清学研究，这些患者在44.38±8.08个月（平均±标准差）期间接受了多种抗癫痫药物治疗，其中使用心磷脂和兔脑磷脂混合物作为抗原，通过酶联免疫吸附测定法检测心磷脂和狼疮抗凝物以确定抗磷脂抗体，此外还使用凝固法检测狼疮抗凝物。进行临床评估以确定在接下来的五年中是否存在血栓形成事件。
这些患者中有43%检测到抗磷脂抗体，其中大多数为抗心磷脂抗体（IgM亚型）。在研究期间患者未出现血栓形成事件。
这些患者中抗磷脂抗体呈高比例阳性，但在研究期间未发现血栓形成。这可能是因为在这些患者中观察到的与狼疮抗凝物阳性无关的心磷脂抗体阳性情况并未带来血栓形成事件的风险。
