Acute Psychotic Symptoms: A manifestation of Antiphospholipid Syndrome or Infarction of Corpus Callosum.

The antiphospholipid syndrome (APS), which is an autoimmune disorder, is characterized by recurrent arterial or venous thrombosis in the presence of circulating antipshospholipid antibodies (Khamashta et al. 2004). The patients are considered to have the APS if they have at least one clinical and at least one labaratory criterion at the same time (Miyakis et al. 2006). APS may be an isolated disease (primary APS) or it may be associated with systemic lupus erythematosus or another autoimmune condition (secondary APS) (del Rio Casanova et al. 2014). APS is seen mostly in young-to-middleaged adults, but it may also occur in children and elderly people. The prevelance of antiphospholipid antibodies was reported to be 2%-5% present in general population (Levine et al. 2002). One of the most prominent feature of APS is Central Nervous System involvement (Hughes 2003, Sanna et al. 2003). Either thrombotic or nonthrombotic neurological symptoms can be associated with APS. Stroke and migrane are the most common clinical features and are seen 20% of the patients. Epilepsy, dementia, chorea, multiple sclerosis-like syndromes, Guillain-Barre-like syndrome and sensorineuronal hearing loss have also been reported associated with APS (Sanna et al. 2003). Some psychiatric disorders/symptoms clusters like depression, anxiety, and psychosis have been reported in association with APS. In addition, increased levels of anticardiolipin antibodies and lupus anticogulants have been reported in untreated psychotic patients (Schwartz et al. 1998). The presenting symptoms of APS can also be psychotic symtoms, and the somatic symptoms may appear later (Kurtz & Multer 1994). Raza et al. (2008) have also reported manic disorder as a psychiatric manifestation of AFS. In addition, Del Rio-Casanova et al. (2014) have reported psychosis as debut of antiphospholopid syndrome. However, the precise pathophysiological mechanisms underlying the association between APS and psychosis have not been identified yet. The circulating antibodies or the thrombotic events may be the key pathological feature. We aimed to discuss the possible association between APS and psychosis with a case report. CASE REPORT