Mielopatie acute in presenza di anti-corpi anti-fosfolipidi. Presentazione di 4 casi clinici

Anti-phospholipid syndrome is defined by widespread arterial and venous thrombosis in association with high hematological titers of anti-phospholidid antibodies. These vascular events could involve, although rarely, also the spinal cord and determine acute myelopathy (in accordance with Jeffery's criteria). In this paper we reported the clinical history of four patients affected by the anti-phospholipid syndrome who presented to our clinics for the appearance of a myelopathic disorder. Anti-phospholid syndrome should be always considered in the differential diagnosis between the possible causes of myelopathy. Among them, the most important are: systemic lupus erythematosus; infections (viral, bacterial or fungine); neoplasms; compressive origin; inflammatory and demyelinization (multiple sclerosis). The most useful clues for the diagnosis we found in our clinical practice are the clinical evaluation of the patient and the course of pathology during time; hematological evaluation of anti-phospholid antibodies; CSF and magnetic resonance imaging of the brain and of the spinal cord. An early diagnosis of the anti-phospholid syndrome is really important for the different therapeutical approach which needs, based on the daily use of anti- aggregant drugs, anti-coagulant and immunosuppressor.