Fukazawa T, Moriwaka F, Mukai M, Hamada T, Koike T, Tashiro K
Hokuyukai Neurology Hospital, Sapporo, Japan.
Acta Neurol Scand. 1993 Sep;88(3):184-9. doi: 10.1111/j.1600-0404.1993.tb04214.x.
We evaluated circulating anticardiolipin antibodies (aCL) in 38 Japanese patients who fulfilled the criteria of clinically definite multiple sclerosis (MS), using a newly developed EIA system with aCL-cofactor. Two of 38 patients (5.3%) had a aCL-cofactor-dependent positive serology, and differences compared with findings in controls were statistically significant. The 2 aCL-positive patients had similar clinical features with acute transverse myelopathy (ATM), optic neuropathy (OPN), normal cranial MRI and negative oligoclonal IgG bands (OCBs) in the cerebrospinal fluid (CSF). Among the 38 patients, 3 had ATM, OPN, normal cranial MRI and negative OCBs, hence, in a significant number of the patients (2/3; 67%) with these distinctive features, serology for aCL was positive. Therefore, they may have another condition associated with aCL, masquerading as MS. Serological testing for aCL with aCL-cofactor is recommended for the patients with clinical diagnosis of MS, especially for those showing OPN and ATM during the clinical course, and in Asian peoples where the incidence of ATM and OPN is relatively high among the patients with diagnosis of MS.
我们使用新开发的含抗心磷脂抗体（aCL）辅因子的酶免疫分析（EIA）系统，对38例符合临床确诊多发性硬化症（MS）标准的日本患者的循环抗心磷脂抗体进行了评估。38例患者中有2例（5.3%）血清学呈aCL辅因子依赖性阳性，与对照组结果相比差异具有统计学意义。这2例aCL阳性患者具有与急性横贯性脊髓炎（ATM）、视神经病变（OPN）相似的临床特征，头颅MRI正常，脑脊液（CSF）中寡克隆IgG带（OCBs）阴性。在这38例患者中，有3例出现ATM、OPN、头颅MRI正常且OCBs阴性，因此，在大量具有这些独特特征的患者（2/3；67%）中，aCL血清学呈阳性。所以，他们可能患有另一种与aCL相关的疾病，伪装成MS。对于临床诊断为MS的患者，尤其是在临床病程中出现OPN和ATM的患者，以及在诊断为MS的患者中ATM和OPN发病率相对较高的亚洲人群，建议进行含aCL辅因子的aCL血清学检测。
