Determining the Correlation Between Antiphospholipid Antibodies and Epilepsy: A Systematic Review
Bibliographic record
Abstract
Abstract Abstract 4629 Background: Seizures are frequently found in patients with autoimmune diseases such as lupus and APS. Recent publications concluded that APLAs are associated with seizures and their presence results in more poor control. Conversely, the presence of auto-antibodies directed against different targets, including APLA, voltage-gated potassium channels, c-aminobutyric acid B receptor, GAD, and others, have been identified in up to 20% of newly-diagnosed epilepsy patients and there is increasing evidence of their pathogenic role. Objective: We sought to evaluate the relationship between epilepsy and antiphospholipid antibodies (APLA) and/or antiphospholipid antibody syndrome (APS). This was done by means of a systematic review of the literature. We sought to answer four questions: 1) Are epilepsy and seizure disorders more prevalent among pts. with aPLAS/aPLAs?; 2) Is aPLAS more prevalent among patients with epilepsy or seizure disorders?; 3) In those with seizure disorders, is there a heightened prevalence of aPLAs?; 4) Does the presence and titre of aPLAs determine the severity and/or frequency of seizures, in these patients? Design/Methods: We conducted a systematic review to evaluate the relationship between APLA (including anticardiolipin Ab, anti beta-2-glycoprotein-1 Ab, and lupus anticoagulant) and epilepsy. We searched MEDLINE, EMBASE, Healthstar, the Cochrane library, LILACS, Scopus and grey literature. We included cohort, case-control, and cross-sectional studies studying the prevalence of epilepsy in patients with APS and/or +APLA, the prevalence of +APLA and/or APS in patients with epilepsy, and the severity of the seizures in patients with +APLA and/or APS. Results: The search retrieved 837 relevant references and 79 were retrieved for full review. We included in the final review 24 studies (19 case-control, 3 cohort and 2 cross-sectional). In 3 cohorts, including 1585 patients with APS, the frequency of epilepsy ranged between 3.4 and 8.5%. In 16 case-control studies, including 3893 patients, the OR for +APLA and/or APS in patients with epilepsy ranged from 0.60 to 13.3 in individual studies. In 2 case-control studies, including 804 patients, the OR for epilepsy in patients with +APLA and/or APS ranged from 0.83 to 2.82 in individual studies. An OR or RR could be calculated in only 17 studies, and within this group, twelve positive and five negative studies were identified. No meta-analysis was conducted due to the high heterogeneity of designs. In 4 studies, an association was found between +APLA and seizure frequency and severity. In positive studies there was no correlation between +APLA, epilepsy and cerebral ischemia. Conclusions: We conclude that +APLA/APS might be related with higher risk and severity of epilepsy, however further studies using accepted consensus definitions for APLA positivity, more stringent methodology and appropriate subgroup analysis are needed. Disclosures: Lazo-Langner: Pfizer: Honoraria; Leo Pharma: Honoraria.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.025 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.012 | 0.014 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".