MR findings in primary antiphospholipid syndrome.

Antiphospholipid antibodies (APLA) are immunoglobulins of the lgG and lgM groups with activity against negatively charged phospholipids. Common manifestations of APLA in­ clude the presence of lupus anticoagulant and anticardiolipin antibodies, and false-positive Venereal Disease Research Laboratory (VORL) and rapid plasma reagin (RPR) tests [1 , 2]. APLA has been associated with an increased frequency of venous and arterial thromboses, recurrent fetal loss, throm­ bocytopenia, cardiac valve lesions, livedo reticularis and other skin lesions, and a variety of neurologic syndromes [1 - 9). The disease has been reported most frequently in patients with systemic lupus erythematosus (SLE) and lupuslike dis­ ease , but also in other clinical entities , including infections, neoplasms, hematologic disorders, AIDS , primary immuno­ deficiency, collagenosis, and following treatment with certain drugs (especially in those associated with drug-induced SLE) [1 ' 2). Recently, a new subgroup of patients who have idiopathic APLA has been described. The diagnostic criteria of this primary antiphospholipid syndrome (PAPS) include a history of venous and{or arterial thrombotic occlusions, recurrent fetal loss or thrombocytopenia, and the presence of lupus anticoagulant, anticardiolipin antibodies, or both, in the ab­ sence of SLE or any other cause of APLA [1 , 2). To make the diagnosis, at least one clinical feature and one positive laboratory test should be present on two different occasions separated by a 2-month interval [2]. We report the MR findings in a case of PAPS clinically resembling multiple scle­ rosis .