HIGH ASSOCIATION OF ANTICARDIOLIPIN ANTIBODIES WITH PSYCHOSIS

Background: Lupus anticoagulant (LA) and anticardiolipin antibodies (a CL) are autoantibodies that can be detected in plasma or serum of pati ents with autoimmune-related diseases. The presence of these autoantib odies has been associated with recurrent arterial and/or venous thromb oembolism as well as with recurrent fetal loss and thrombocytopenia. I n recent years, other medical conditions such as dementia, chorea, psy chosis, migraine, and peripheral neuropathy have been associated with these autoantibodies. An adverse response to neuroleptic treatment was reported to be associated with the presence of autoantibodies, but th ese patients rarely developed clinical vascular manifestations. Method : We conducted a study of 34 unmedicated patients admitted to the hosp ital with acute psychosis in whom aCL and LA were examined before and after neuroleptic treatment to determine the presence of antibodies re lative to the treatment condition. Results: 32% (11/34) of the unmedic ated psychotic patients had antiphospholipid antibodies: we detected e levated titers of IgG-aCL isotype in 24% (8/34) of unmedicated patient s (p <.02 compared with 20 normal controls, none of whom tested positi ve), and 9% (3/34) had LA. Twenty-two patients were followed up after medication; 31.8% (7/22) of these patients showed moderate titers of I gG-aCL (p <.28), and 18.2% (4/22) were LA positive. Altogether, antiph ospholipid antibodies were detected in 40.9% (9/22) of the medicated p atients. Conclusion: This study shows the increased incidence of LA an d aCL antibodies in neuroleptic-treated psychotic patients and the pos sible association between psychosis and antiphospholipid antibodies.