Abstract

This paper describes a 39-year-old woman who developed two rare conditions affecting her brain and placenta, which the authors linked to antiphospholipid syndrome (APS). APS is an immune-related condition associated with pregnancy complications and problems affecting blood vessels.

During her first pregnancy, the woman became increasingly clumsy with both hands. Her baby died in the womb at 18 weeks. Examination of the placenta showed chronic histiocytic intervillositis: a build-up of immune cells in the spaces surrounding the placental tissue, with some accumulation of a clotting protein called fibrin. These changes prevented the placenta from working properly.

Blood tests repeatedly detected antiphospholipid antibodies. After another miscarriage, her neurological difficulties worsened rapidly. She developed problems with skilled finger movements, language, calculation, understanding spatial relationships, and remembering verbal information. Brain scans showed damage in several areas. Imaging of the brain’s blood vessels revealed irregular narrowing, while a brain biopsy showed blocked small vessels, surrounding immune cells, and tiny areas of tissue damage caused by inadequate blood supply.

Disturbed immune activity associated with APS may explain both conditions. However, this is a single case report, so it cannot prove a shared cause or establish how frequently these complications occur. The case highlights how APS may connect seemingly unrelated complications in the brain and placenta through a shared disturbance of the immune system.