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Q J Med 2000; 93: 497-499
© 2000 Association of Physicians

Editorial

Warfarin for multiple sclerosis?

G. Ruiz-Irastorza and M.A. Khamashta

Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, London

In 1983, Poser et al.1 established their criteria for the diagnosis of multiple sclerosis (MS). In the same year, Hughes2 described the association between thrombosis, abortion, cerebral disease and lupus anticoagulant. These reports have eventually become connected. Today, almost 20 years later, there are enough data to consider antiphospholipid syndrome (APS), or Hughes' syndrome, as a major differential in the diagnosis of definite or probable MS according to Poser's criteria.

Arterial thrombosis is a major feature of Hughes' syndrome, central nervous system vessels being among the most frequently affected.3 The resulting clinical event is generally a stroke. However, more complex manifestations may include multifocal sensory, motor or cognitive dysfunction, optic neuritis, transverse myelitis and a combination of the last two (Devic's syndrome). Different areas are often affected during the progression of the disease. . . . [Full Text of this Article]

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