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Clinical and Developmental Immunology
Volume 2012, Article ID 981519, 7 pages
Research Article

Seizures in Primary Antiphospholipid Syndrome: The Relevance of Smoking to Stroke

1Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 01246-903 São Paulo, SP, Brazil
2Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de Campinas, Campinas, SP, Brazil

Received 20 November 2011; Accepted 14 January 2012

Academic Editor: Clelia M. Riera

Copyright © 2012 Jozélio Freire de Carvalho et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To evaluate the frequency of seizures in primary antiphospholipid syndrome (PAPS) and their possible clinical and laboratory associations. Methods. Eighty-eight PAPS patients (Sydney’s criteria) were analyzed by a standard interview, physical examination and review of medical charts. Risk factors for seizures, clinical manifestations, associated comorbidities, and antiphospholipid antibodies were evaluated. Results. Nine (10.2%) patients with seizures were identified, 77.8% had convulsions onset after PAPS diagnosis. Mean age, gender, and race were comparable in groups with or without seizures. Interestingly, a higher frequency of current smoking (44.4 versus 10.1%, 𝑃 = 0 . 0 1 9 ) was observed in the first group. Stroke, Sneddon’s syndrome, and livedo reticularis were more frequent in PAPS patients with seizures than those without seizures, although not statistically significant ( 𝑃 > 0 . 0 5 ). Comparison between patients with seizures onset after PAPS diagnosis ( 𝑛 = 7 ) and those without convulsions ( 𝑛 = 7 9 ) demonstrated a higher frequency of current smoking (42.9 versus 10%, 𝑃 = 0 . 0 4 2 ) and stroke in the first group (71.4 versus 30.4%, 𝑃 = 0 . 0 4 1 ). Regression analysis confirmed that smoking ( 𝑃 = 0 . 0 3 0 ) and stroke ( 𝑃 = 0 . 0 4 2 ) were independently associated to seizures. Conclusion. About 10.2% of PAPS patients had convulsions, predominantly after PAPS diagnosis, and seizures were associated to current smoking and stroke.