Stroke and the antiphospholipid syndrome: consensus meeting Taormina 2002

Ischaemic stroke is the only neurologicalmanifestation accepted as a clinical diagnostic criterion for the antiphospholipidsyndrome (APS). This association is reasonablywell established in patients rst diagnosed with APS but is less clear in randomly selected stroke patients who test positive on one occasion for antiphospholipid antibodies and who have no other evidence of systemic autoimmune disease.We propose a grading system that posits stroke to be de nitely, likely or possibly associated with antiphospholipid antibodies (aPL). Further, there are limited prospective data to determine appropriate treatment. There is controversy as to whether the presence of aPL even increases risk of a recurrent stroke or other thromboembolic event, although data point to persistent medium-high titre aCL and/or LA as risk factors for recurrence. In the absence of data to guide clinicians on the best treatment, we cannot make strong recommendations as to optimal therapy, nor can we propose clear consensus treatment guidelines. Lupus (2003) 12, 508–513. Key words: anticoagulant therapy; antiphospholipidantibodies;antiphospholipidsyndrome; cerebro-vascular disorders; lupus anticoagulant; stroke Background There are a number of issues which need to b