L'association entre syndrome des anticorps anti-phospholipides et vascularite est rare. Nous rapportons le cas d'un patient de 30 ans avec des manifestations neurologiques centrales et périphériques d'une périartérite noueuse et des anticorps anti-phospholipides associés. Un traitement immunosuppresseur par cyclophosphamide IV et corticoïdes oraux associé à une anticoagulation par anti-vitamine K a permis une stabilisation clinique.

The association between antiphospholipid syndrome (APS) and vasculitis is rare and continues to evoke great interest. We report a case with neurological manifestations of polyarteritis nodosa (PAN) and concurrent APS.

Electromyography and neuromuscular biopsy of the limb showed an axonal polyneuropathy following obliteration and necrosis of medium sized arteries, initially suggesting PAN. This vasculitis was confirmed on visceral selective arteriography, with the presence of numerous anevrysms.

Cerebral MRI revealed multiple cortical and subcortical signals in the fronto-parietal areas, corresponding to ischemic microvascular lesions of APS. This association was confirmed by the presence IgG anticardiolipid, the past medical history of skin necrotic lesions and central retinal obliteration.

Pulse intravenous cyclophosphamide, oral prednisolone and curative anticoagulation led to stabilization for 8 months.