Clinical and neuroradiological aspects of Sneddon's syndrome and primary antiphospholipid antibody syndrome. A follow-up study

We performed a study to investigate differences and similarities between pa tients with Sneddon's syndrome and those with primary antiphospholipid synd rome (PAS), by clinical follow-up, magnetic resonance imaging (MRI) and ang iography. Nine patients with Sneddon's syndrome and 11 patients with PAS we re assessed at diagnosis and followed for a mean of 6 years. The clinical a nd MRI findings indicated that Sneddon's syndrome and PAS are distinct enti ties. Patients with Sneddon's syndrome had a progressive clinical course wi th increasing disability and cognitive deterioration; patients with PAS had a more benign course. Infarcts in territories of the main cerebral arterie s were frequent in PAS, while leukoaraiosis and small lacunar infarcts were more common in Sneddon's syndrome. In 3 of 7 women initially diagnosed wit h PAS, the diagnosis was changed to systemic lupus erythematosus during fol low-up. Differential diagnosis of Sneddon's syndrome and PAS is important, as early therapy is effective for the latter, more benign, condition.