Mononeuritis multiplex due to thrombotic ischemia of primary antiphospholipid antibody syndrome without vasculitis: an autopsy case report
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- Takahashi Masatoshi
- Department of Neurology, Kameda General Hospital Department of Neurology, Shinko Hospital
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- Katada Fumiaki
- Department of Neurology, Kameda General Hospital
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- Sato Susumu
- Department of Neurology, Kameda General Hospital
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- Shibayama Hidehiro
- Department of Neurology, Kameda General Hospital
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- Fukutake Toshio
- Department of Neurology, Kameda General Hospital
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- Murayama Shigeo
- Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
Bibliographic Information
- Other Title
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- 血管炎を伴わず，血栓性虚血により多発性単神経炎を呈した原発性抗リン脂質抗体症候群の1剖検例
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Abstract
The patient was a 78-year-old man. Three years before admission, he developed transient peripheral neuropathy and purpura, and at admission, he presented with livedo reticularis of both his lower extremities and with mononeuritis multiplex. Vasculitis was not observed, and antiphospholipid antibodies were detected. The nerve and skin biopsies revealed no inflammation; axonal degeneration accompanied by thrombi was found in his arterioles and venules. Based on these findings, he was diagnosed with ischemic peripheral neuropathy due to primary antiphospholipid syndrome. Administration of anticoagulant therapy resulted in an improvement in symptoms; however, two months later, a relapse occurred, and the patient contracted an infection while undergoing immunosuppressive therapy. The infection became fulminant, and the patient succumbed to multiple organ failure. The autopsy revealed a systemic arterial and venous embolism; however, no vasculitis was observed. Antiphospholipid syndrome, which is responsive to antithrombotic treatment, should be considered as a differential diagnosis of mononeuritis multiplex.
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 55 (12), 897-903, 2015
Societas Neurologica Japonica
