Anticardiolipin Antibodies in Oculocerebral Ischaemia and Migraine: Prevalence and Prognostic Value

Abstract

We prospectively studied the prevalence and prognostic value of anticardiolipin antibodies (ACLA) in 72 unselected patients with acute or chronic oculocerebral ischaemia (OCI) and 25 patients with migraine. ACLA were measured by ELISA. ACLA titres above 12 GPL-U/ml or 6 MPL-U/ml were considered abnormal. Thirty-two of 72 patients with OCI (44%) showed weakly elevated IgG- or IgM-ACLA (i.e. < 20 GPIVMPL-U/ml). In 9 patients (12%) ACLA titres were above 20 GPL/MPL-U/ml. High ACLA titres in patients with OCI were associated with a significantly increased risk for recurrent cerebral ischaemia. In patients with low ACLA titres, recurrence of ischaemia was no more frequent than in ACLA-negative patients. We suggest that weakly elevated ACLA have no potency for inducing a prothrombotic state and therefore are of no clinical relevance in stroke patients. Serial studies of ACLA titres performed in some patients showed marked fluctuation over time indicating that single determinations should be interpreted with caution. Fifteen of 25 patients with migraine (60%) showed weakly (n = 14, 56%) or highly positive (n = 1, 4%) ACLA titres. Whether ACLA assume a pathogenetic role in migraine remains unknown.