OBJECTIVE: To describe the neuroradiologic findings of primary antiphospholipid antibody syndrome (PAPS). MATERIALS AND METHODS: During a recent two-year period, abnormally elevated antiphospholipid antibodies were detected in a total of 751 patients. In any cases in which risk factors for stroke were detected-hypertension, diabetes mellitus, hyperlipidemia, smoking, and the presence of SLE or other connective tissue diseases-PAPS was not diagnosed. Neuroradiologic studies were performed in 11 of 32 patients with PAPS. We retrospectively reviewed brain CT (n = 7), MR (n = 8), and cerebral angiography (n = 8) in 11 patients with special attention to the presence of brain parenchymal lesions and cerebral arterial or venous abnormalities. RESULTS: CT or MR findings of PAPS included nonspecific multiple hyper-inten-sity foci in deep white matter on T2-weighted images (5/11), a large infarct in the territory of the middle cerebral artery (4/11), diffuse cortical atrophy (2/11), focal hemorrhage (2/11), and dural sinus thrombosis (1/11). Angiographic findings were normal (5/8) or reflected either occlusion of a large cerebral artery (2/8) or dural sinus thrombosis (1/8). CONCLUSION: Neuroradiologic findings of PAPS are nonspecific but in young or middle-aged adults who show the above mentioned CT or MR findings, and in whom risk factors for stroke are not present, the condition should be suspected.
Adult ; Antiphospholipid Syndrome/*radiography ; Brain/pathology/*radiography ; Cerebral Angiography ; Female ; Human ; Magnetic Resonance Imaging ; Male ; Middle Age ; Risk Factors ; Tomography, X-Ray Computed

There are various causes of splenic infarction. Antiphospholipid antibody is associated with numerous thromboembolic phenomena. We report a case of young male who presented with acute abdominal pain and was diagnosed as a case of splenic infarction and acute pancreatitis with antiphospholid syndrome. He was positive for anticardiolipin antibody, showed splenic infarction on abdominal CT scan. The patient's clinical, laboratory and imaging finding were consistent with splenic infarction and acute pancreatitis associated with antiphospholipid syndrome.
Acute Disease ; Adult ; Antiphospholipid Syndrome/*complications/diagnosis ; Humans ; Male ; Pancreatitis/*diagnosis/etiology ; Splenic Infarction/*diagnosis/etiology/radiography ; Tomography, X-Ray Computed

PURPOSE: To describe the chest radiographic and CT findings of diffuse pulmonary hemorrhage. MATERIALS AND METHODS: Two radiologists retrospectively analysed the chest radiographic and CT findings of six patients withdiffuse pulmonary hemorrhage. Using open lung biopsy (n=2) and transbronchial lung biopsy or bronchoalveolarlavage (n=4), diagnosis was based on the presence of hemosiderin-laden macrophage or intra-alveolar hemorrhage.Underlying diseases were Wegener's granulomatosis (n=2), antiphospholipid antibody syndrome (n=2),Henoch-Schonlein purpura (n=1), and idopathic pulmonary hemosiderosis (n=1). In all patients, sequential chestradiographs, obtained during a one to six-month period, were available. HRCT scans were obtained in five patients,and conventional CT scans in one. Follow-up HRCT scans were obtained in two. We also analyzed the patterns ofinvolvement, distribution and sequential changes in the pulmonary abnormalities seen on chest radiographs and CTscans. RESULTS: Chest radiographs showed multifocal patchy consolidation (n=6), ground-glass opacity (n=3), andmultiple granular or nodular opacity (n=3). These lesions were intermingled in five patients, while in one therewas consolidation only. Sequential chest radiographs demonstrated the improvement of initial pulmonaryabnormalities and appearance of new lesions elsewhere within 5-6 days, though within 7-25 (average, 13) days,these had almost normalized. HRCT scans showed patchy consolidation (n=5), multiple patchy ground-glass opacity(n=5), or ill-defined air space nodules (n=4). These lesions were intermingled in five patients, and in one,ground-glass opacity only was noted. In two patients there were interlobular septal thickening and intralobularreticular opacity. The distribution of these abnormalities was almost always bilateral, diffuse with no zonalpredominancy , and spared the apex of the lung and subpleural region were less affected. CONCLUSION: Althoughchest radiographic and CT findings of diffuse pulmonary hemorrhage are nonspecific, sequential changes inbilateral multifocal patchy consolidation and ground-glass opacity, accompanied by clinical symptoms such ashemoptysis or anemia, may be helpful in the diagnosis of diffuse pulmonary hemorrhage.
Anemia ; Antiphospholipid Syndrome ; Biopsy ; Diagnosis ; Follow-Up Studies ; Hemorrhage* ; Hemosiderosis ; Humans ; Lung ; Macrophages ; Purpura ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed ; Wegener Granulomatosis