Hachulla E, Leys D, Deleume J F, Pruvo J P, Devulder B
Service de Médecine Interne, Hôpital Claude-Huriez, CHRU, Lille, France.
Rev Med Interne. 1995;16(2):121-30. doi: 10.1016/0248-8663(96)80676-x.
Antiphospholipid antibody is associated with a clinical syndrome of vascular thrombosis, thrombocytopenia, recurrent fetal loss and livedo reticularis, whether or not a clinical diagnosis of systemic lupus erythematosus (SLE) coexists. Central nervous system involvement in SLE is multifactorial, thrombotic events, antineuronal antibodies, hypertension, infection, side effects of drugs etc. Antiphospholipid antibodies may play a role in focal neurological manifestations in SLE. In the absence of SLE, different neurological symptoms are well associated with antiphospholipid antibodies including stroke, seizures, dementia, migraine, ocular ischemia, chorea, transverse myelopathy, cerebral phlebitis. Other association are more controversal like Guillain Barré syndrome, motor neuron disease, communicating hydrocephalus. In all patients with antiphospholipid antibodies with neurological involvement, cerebral MRI may be performed with an echocardiographic study because a possible association with Libman and Sacks endocarditis, valve dysfunction or cardiac thrombus source of cerebral ischemia.
抗磷脂抗体与血管血栓形成、血小板减少、反复流产和网状青斑的临床综合征相关，无论是否并存系统性红斑狼疮（SLE）的临床诊断。SLE的中枢神经系统受累是多因素的，包括血栓形成事件、抗神经元抗体、高血压、感染、药物副作用等。抗磷脂抗体可能在SLE的局灶性神经表现中起作用。在无SLE的情况下，不同的神经症状与抗磷脂抗体密切相关，包括中风、癫痫发作、痴呆、偏头痛、眼部缺血、舞蹈症、横贯性脊髓炎、脑静脉炎。其他关联更具争议性，如格林-巴利综合征、运动神经元病、交通性脑积水。在所有有神经受累的抗磷脂抗体患者中，可进行脑部MRI检查并进行超声心动图研究，因为可能与Libman和Sacks心内膜炎、瓣膜功能障碍或脑缺血的心脏血栓来源有关。
