ANTICARDIOLIPIN ANTIBODIES IN OCULOCEREBRAL ISCHEMIA AND MIGRAINE - PREVALENCE AND PROGNOSTIC VALUE

We prospectively studied the prevalence and prognostic value of antica rdiolipin antibodies (ACLA) in 72 unselected patients with acute or ch ronic oculocerebral ischaemia (OCI) and 25 patients with migraine. ACL A 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%) sho wed weakly elevated IgG- or IgM-ACLA (i.e. < 20 GPL/MPL-U/ml). In 9 pa tients (12%) ACLA titres were above 20 GPL/MPL-U/ml. High ACLA titres in patients with OCI were associated with a significantly increased ri sk for recurrent cerebral ischaemia. In patients with low ACLA titres, recurrence of ischaemia was no more frequent than in ACLA-negative pa tients. We suggest that weakly elevated ACLA have no potency for induc ing a prothrombotic state and therefore are of no clinical relevance i n stroke patients. Serial studies of ACLA titres performed in some pat ients showed marked fluctuation over time indicating that single deter minations should be interpreted with caution. Fifteen of 25 patients w ith migraine (60%) showed weakly (n = 14, 56%) or highly positive (n = 1, 4%) ACLA titres. Whether ACLA assume a pathogenetic role in migrai ne remains unknown.