To highlight the relationship between persistent aPL and peripheral neuropathy through a retrospective review

Antiphospholipid syndrome (APS) is an autoimmune disorder commonly associated with thrombotic events, recurrent miscarriages, and thrombocytopenia, along with persistent antiphospholipid antibodies (aPL). While APS is commonly linked to central nervous system (CNS) manifestations, such as cerebral ischemia and venous thrombosis, its involvement in peripheral nervous system (PNS) disorders remains less understood. Previous reports have suggested that aPL may contribute to conditions such as Guillain-Barré syndrome, idiopathic polyneuropathy, and autonomic disorders, possibly through direct nerve damage and ischemic thrombosis of the vasa nervorum.

A final cohort of ten patients (seven female, three male) was analyzed. Five patients had a length-dependent NCS/EMG pattern, four showed a multifocal pattern, and one demonstrated small fiber neuropathy. Three patients underwent nerve biopsy, with two showing perivascular inflammation. All patients tested positive for lupus anticoagulant, though no components of a specific aPL profile, such as quantity, types, and persistence, were identified. 

This study highlights the potential, but rather uncommon association between lupus anticoagulant and aPL and various forms of peripheral neuropathy, including length-dependent, multifocal, and small fiber types, as well as the potential role of perivascular inflammation. This study cannot prove a causal relation. These findings suggest that patients with idiopathic neuropathies should be evaluated for presence of serum aPL.