REFRACTORY HICCOUGH HERALDING TRANSVERSE MYELITIS IN THE PRIMARY ANTIPHOSPHOLIPID SYNDROME

The case of a 32-year-old female patient with a primary form of the an tiphospholipid syndrome is presented. The initial symptom was a pathol ogical form of hiccough, refractory to conventional therapy that was f ollowed, weeks later, by a full-blown picture of transverse myelitis. Despite the fact that transverse myelitis has been described as associ ated with the presence of antiphospholipid antibodies, we could not fi nd the description of refractory hiccough as the initial manifestation of the antiphospholipid syndrome. The administration of steroids, hep arin and plasmapheresis resulted in resolution of the neurological sym ptoms.