Wan L, Liu T, Chen T, et al. - Findings demonstrate a high prevalence of brain magnetic resonance imaging (MRI) abnormalities in primary antiphospholipid syndrome (PAPS) patients and antiphospholipid antibodies (aPL) carriers, which indicates an elevated cerebrovascular risk, calling for attention to silent cerebral lesions in persistently aPL positive cases.

• A single-center, observational cross-sectional study was conducted with 44 PAPS patients, 24 aPL carriers and 23 healthy controls with comparable age and gender.

• Participants underwent cerebral MRI, and abnormal MRI findings were found in 38 (55.88%) patients while only one healthy control had some abnormalities in the MR findings.

• In aPL (+) group, the most frequent MRI abnormality was lacunes, followed by white matter hyperintensities.

• In all study population, independent associated factors with the brain MRI abnormalities were: age (OR = 1.086) and LA positivity (OR = 5.191).

• On analyzing only in the aPL (+) group, the following were revealed as significant independent risk factors with abnormal MRI: age (OR = 1.116), female gender (OR = 7.519) and thrombocytopenia (OR = 8.336).