This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hilker, R Articles by Rudolf, J Search for Related Content PubMed PubMed Citation Articles by Hilker, R Articles by Rudolf, J Social Bookmarking                   What's this?

Cerebral blood flow and glucose metabolism in multi-infarct-dementia related to primary antiphospholipid antibody syndrome

Klinik und Poliklinik für Neurologie, UniversitätzuKöln, Joseph-Stelzmann-Strabe9,D-50924 Köln, Germany. Tel: (/49) 221 478 4182; Fax:(/49) 221 478 3482 Hilker{at}pet.mpin-koeln.mpg.de

A Thiel

Klinik und Poliklinikfür Neurologie der UniversitätzuKöln, Köln,Germany

C Geisen

Institut für Klinische Chemie der UniversitätzuKöln, Köln,Germany

J Rudolf

Klinik undPoliklinikfür Neurologie der UniversitätzuKöln, Köln,Germany

The primary antiphospholipid antibody syndrome (PAPS) has beendescribed in patients with a history of fetal loss,thrombocytopenia and arterial or venous thrombosis. In PAPS, a prothrombotic state is mediated by antiphospholipid antibodies (aPLs) leading to disseminated thromboembolic vascular occlusion. Today, the presence of aPLs in the serumis considered as a distinct risk factor for recurrent stroke in young adults. Some PAPS patients develop a multi-infarct-syndrome with a stepwise decline of higher cortical functions. We report on a 55-year-old man suffering from progressive dementia and PAPS, in whom cerebral glucose metabolism and blood flow were examined by positron emission tomograpy (PET). Cerebral atrophy and moderate signs of leukaraiosis were detected in magnetic resonance imaging (MRI), whereas the PET scans showed a considerable diffuse impairment of cortical glucose metabolism combined with a reduced cerebral perfusion in the arterial border zones. These findings indicate that PAPS-associated vascular dementia is accompanied by a cortical neuronal loss, presumably caused by a small-vessel disease with immune-mediated intravascular thrombosis. This case shows that pathological findings in PAPS are congruent to cerebral changes of metabolism and blood flow in systemic lupus erythematosus (SLE).

Key Words: primary antiphospholipid antibody syndrome (PAPS) • cerebral glucose metabolism • regional cerebral blood flow • multi-infarct-dementia (MID) • positron emission tomography (PET)

Lupus, Vol. 9, No. 4, 311-316 (2000)
DOI: 10.1191/096120300680199015


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				H Tatsukawa, K Ishii, M Haranaka, M Kumagi, I Hino, and H Yoshimatsu Evaluation of average amount of cerebral blood flow measured by brain perfusion index in patients with neuropsychiatric systemic lupus erythematosus. Lupus, June 1, 2005; 14(6): 445 - 449. [Abstract] [PDF]

				J. A. Gomez-Puerta, R. Cervera, L. M. Calvo, B. Gomez-Anson, G. Espinosa, G. Claver, S. Bucciarelli, A. Bove, M. Ramos-Casals, M. Ingelmo, et al. Dementia associated with the antiphospholipid syndrome: clinical and radiological characteristics of 30 patients Rheumatology, January 1, 2005; 44(1): 95 - 99. [Abstract] [Full Text] [PDF]

				A Katzav, J Chapman, and Y Shoenfeld CNS dysfunction in the antiphospholipid syndrome Lupus, December 1, 2003; 12(12): 903 - 907. [Abstract] [PDF]

				R L Brey, J Chapman, S R Levine, G Ruiz-Irastorza, R H. Derksen, M Khamashta, and Y Shoenfeld Stroke and the antiphospholipid syndrome: consensus meeting Taormina 2002 Lupus, July 1, 2003; 12(7): 508 - 513. [Abstract] [PDF]

				G. Sanna, M. L. Bertolaccini, M. J. Cuadrado, M. A. Khamashta, and G. R. V. Hughes Central nervous system involvement in the antiphospholipid (Hughes) syndrome Rheumatology, February 1, 2003; 42(2): 200 - 213. [Abstract] [Full Text] [PDF]

				F D Juengling, J Kassubek, and S M Weiner Cerebral glucose metabolism in Sneddon's syndrome associated with antiphospholipid antibodies Lupus, April 1, 2001; 10(4): 309 - 310. [PDF]