Multiple sclerosis, neuropsychiatric lupus and antiphospholipid syndrome: where do we stand?

• Published in: Rheumatology (Oxford, England) Vol. 44; no. 4; pp. 434 - 442
• Main Authors: Ferreira, S., D'Cruz, D. P., Hughes, G. R. V.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2005; Oxford Publishing Limited (England)
• Subjects: Antibodies, Antiphospholipid - analysis; antiphospholid syndrome; Antiphospholipid Syndrome - diagnosis; Antiphospholipid Syndrome - drug therapy; Biological and medical sciences; Dermatology; Diagnosis, Differential; differential diagnosis; Hematologic and hematopoietic diseases; Humans; Lupus Vasculitis, Central Nervous System - diagnosis; Lupus Vasculitis, Central Nervous System - drug therapy; Magnetic Resonance Imaging; Medical sciences; multiple sclerosis; Multiple Sclerosis - diagnosis; Multiple Sclerosis - drug therapy; Multiple Sclerosis - immunology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; multiple sclerosis-like illness; Neurology; neuropsychiatric lupus; Platelet diseases and coagulopathies; Prognosis; Skin involvement in other diseases. Miscellaneous. General aspects; Lupus; Skin disease; Nervous system diseases; Multiple sclerosis; differential diagnosis; Antiphospholipid antibody syndrome; Cardiovascular disease; Autoimmune disease; multiple sclerosis-like illness; Hemopathy; Inflammatory disease; Vascular disease; Platelet; neuropsychiatric lupus; Central nervous system disease; Diagnosis; antiphospholid syndrome
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/keh532

Multiple sclerosis (MS), systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are chronic, immune-mediated, relapsing–remitting disorders affecting young adults, the pathogenesis of which is still largely unknown. Neurological manifestations and magnetic resonance imaging (MRI) can be indistinguishable and there are no specific diagnostic tools. Treatment and prognosis are quite different. There is controversy about the prevalence and significance of antiphospholipid antibodies (aPL) in MS. A significant number of patients with APS/SLE are misdiagnosed as MS but evidence suggests they are distinct nosological entities. However, it is essential to differentiate them since APS may be responsive to anticoagulation. When assessing MS patients, clinicians should consider APS/SLE, especially if the MS has atypical features. A trial of anticoagulation might be worthwhile in some patients with atypical MS and consistently positive aPL.