Multipl Skleroz Olarak Yanlış Teşhis Edilen Antifosfolipid Sendromu: Bir Olgu Sunumu.

Öz

Multipl skleroz ve anti-fosfolipid sendromu (AFAS), genç yetişkinleri etkileyen kronik, immün aracılı, relapsing-remitting bozukluklardır. AFAS, anti-fosfolipid antikorları ile ilişkili tromboz ve gebelik mortalitesi ile karakterizedir. AFAS tanısı zor olabilir ve AFAS’lı hastaların yanlış multipl skleroz tanısı alması nadir değildir. Bu olgu sunumunda, on bir yıldır multipl skleroz tanısı ile izlenen bir hastayı tanımladık. Başlangıçta hastanın MS benzeri relapsing- remitting seyirli nörolojik defisitleri vardı ancak MS'in klasik manyetik rezonans görüntüleme görünümü ve beyin omurilik sıvısında oligoklonal bantlar yoktu. Hasta MS tanı kriterlerinde belirtilen ‘zamanda ve mekanda yayılım kriterleri’ ni karşılamıyordu. Ayrıca farklı zamanlarda akut miyokard infarktüsü ve iskemik inme geçirmişti. Primer AFAS tanısı, hastanın iskemik serebral inme geçirmesi, nöbet ve iki kez aPL pozitif olması üzerine konuldu. Gözlemlerimiz, AFAS’ın erken ve doğru teşhisinin önemi konusunda farkındalık yaratmaktadır. MS hastalarını değerlendirirken, klinisyenler MS'nin atipik özellikleri varsa AFAS’ı düşünmelidir.

Anahtar Kelimeler

• Multiple Skleroz
• Anti-fosfolipid sendrom
• Yanlış tanı
• Multiple Skleroz benzeri sendrom

Anti-Phosholipid Syndrome Misdiagnosed As Multiple Sclerosis: A Case Report.

Öz

Multiple sclerosis (MS) and anti-phospholipid syndrome (APS) are chronic, immune-mediated, relapsing-remitting disorders affecting young adults. APS is characterized by thrombosis and pregnancy mortality associated with anti-phospholipid antibodies. The diagnosis of APS may be difficult, and it is not uncommon for patients with APS to be misdiagnosed with multiple sclerosis. In this case report, we describe a patient who was diagnosed as having multiple sclerosis for eleven-year. Initially, the patient had neurological deficits with relapsing-remitting courses, like MS but he had not classic magnetic resonance imaging appearance of MS and absence of oligoclonal bands in the cerebrospinal fluid. He did not meet the 'dissemination criteria in time and place' specified in the MS diagnostic criteria. Also, he had an acute myocardial infarction and ischemic stroke at different times. The diagnosis of primary APS was made after the patient had thrombotic attacks, seizure and was positive for anti-phospholipid antibodies (aPLs) twice. Our observations raise awareness about the importance of the early and correct diagnosis of APS. When assessing MS patients, clinicians should consider APS, if the MS has atypical features.

Anahtar Kelimeler

• Multiple Sclerosis
• Anti-phospholipid syndrome
• Misdiagnosis Multiple sclerosis-like syndrome

Kaynakça

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