Thromboembolic disease involving the central nervous system in a patient with the antiphospholipid syndrome may closely resemble multiple sclerosis (MS). The diagnosis of antiphospholipid syndrome should be considered in any patient with possible MS.


A patient with the antiphospholipid syndrome may:

(1) have clinical findings similar to MS

(2) have brain MRI changes similar to MS

(3) show oligoclonal bands in the CSF


When to consider the diagnosis of antiphospholipid syndrome:

(1) multiple sclerosis like syndrome with an atypical clinical course

(2) MRI findings unusual for multiple sclerosis

(3) presence of an underlying connective tissue disease

(3a) livedo reticularis

(3b) photosensitivity

(3c) arthritis

(3d) sicca syndrome

(3e) presence of autoantibodies

(4) clinical findings suggesting the antiphospholipid antibody syndrome

(4a) presence of antiphospholipid antibody

(4b) fetal wastage (if the patient is female)

(4c) unexplained arterial and/or venous thrombi

(5) clinical improvement following initiation of anticoagulation therapy


Multiple sclerosis and the antiphospholipid antibody syndrome can occur in the same patient but it would be much more likely for the patient to have one or the other.


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