Antiphospholipid syndrome with isolated CNS manifestations and multiple sclerosis-like syndrome

Abstract

The antiphospholipid syndrome is a systemic autoimmune disorder characterized by the presence of circulating procoagulant autoantibodies and the occurrence of recurrent arterial or venous thrombosis. Central nervous system manifestations are common and include stroke, transient ischemic attacks, cognitive dysfunction, migraine, seizures, movement disorders, psychiatry symptoms, multiple sclerosis-like syndrome, transverse myelitis and retrobulbar neuritis. Isolated neurological antiphospholipid syndrome may represent a significant diagnostic challenge, as epidemiological, clinical and neuroimaging features may overlap with those of multiple sclerosis. Differential diagnosis between multiple sclerosis and antiphospholipid syndrome is very difficult but it is extremely important because prompt and correct treatment can improve quality of life and may also reduce mortality in the affected patients.
We present a clinical case of antiphospholipid syndrome, misdiagnosed as multiple sclerosis in 29-year-old patient, who was sent to UMHATNP “St. Naum” for initiating disease modifying therapy. The diagnosis was revised and the patient was consulted with reumatolagist and hematologist, an oral anticoagulant therapy was started.