aCL IgG levels and incidence of acute ischemic encephalopathy in SAPS, aCL IgM and epilepsy in SAPS, aCL IgM and migraine in PAPS, ß2GPI IgG and chorea in SAPS and ß2GPI IgM and TIA and epilepsy

Central nervous system involvement is one of the most prominent clinical manifestations of antiphospholipid syndrome (APS), and includes thrombotic events, psychiatric features and a variety of other non-thrombotic neurological syndromes. The aim of our prospective study was to investigate relationship between nonthrombotic neurological and cardiac manifestations. We analyzed 218 patients with primary (PAPS) and 115 patients with secondary APS (SAPS). Chorea, migraine and epilepsy occurred more frequently in SAPS, while headache and depression were more common in PAPS. Patients from both subgroups with unstable angina pectoris were more prone to TIA, epilepsy and transient global amnesia in PAPS and acute ischemic encephalopathy in SAPS. Patients with valve vegetations were more prone to epilepsy and depression. We revealed positive relationship between serum aCL IgG levels and incidence of acute ischemic encephalopathy in SAPS, aCL IgM and epilepsy in SAPS, aCL IgM and migraine in PAPS, ß2GPI IgG and chorea in SAPS and ß2GPI IgM and TIA and epilepsy in PAPS. LA was linked to more frequent occurrence of depression, transient global amnesia, and migraine in PAPS. In summary, we revealed strong link between some non-thrombotic neurological and cardiac manifestations in APS patients, underlying complexity and evolutionary nature of APS which highlights the outstanding need for multidisciplinary approach to treatment of these patients Manuscript received July 26, 2011. This work was supported by research grant number 175041 for 2011 2014, issued by the Ministry of Science of the Republic of Serbia. Prof dr Ljudmila Stojanovich, MD, PhD, Department of Rheumatology, University Medical Center “Bezanijska Kosa”, Belgrade, Serbia (phone: +381113010777, fax:+381112606520, e-mail: [email protected]) Aleksandra Djokovic MD, Depratment of Cardiology, University Medical Center “Bezanijska Kosa”, , Belgrade (e-mail: [email protected]) Milica Kontic MD, Institute of pulmonary disease, Clinical Centre of Serbia, (e-mail: [email protected]) Dusica Smiljanic MD, Department of Neurology, Clinical-Hospital Center “ Zemun”, Belgrade, Serbia, (e-mail: [email protected]) Vladimir Bojovic MD, PhD, Department of Neurology, Clinical-Hospital Center “ Zemun”, Belgrade, Serbia Prof dr Nenad Ilijevski MD, PhD, Institute of Cardiovascular Diseases “Dedinje”, Belgrade, Serbia, (e-mail: [email protected]) Prof dr Dragomir Marisavljevic MD, PhD, Department of Hematology, University Medical Center, “Bezanijska Kosa”, Belgrade, Serbia (e-mail: [email protected].) Keywords—antiphospholipid syndrome, non-thrombotic neurological manifestations, non-thrombotic cardiac manifestations.