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A case of multiple sclerosis associated with rheumatoid arthritis and positive anticardiolipin antibodies

We describe the case of a 59 year old man with longstanding multiple sclerosis (MS) since his early fifties, who after many years developed the clinical and serological manifestations of erosive rheumatoid arthritis (RA). This rare association is interesting owing to the overlapping pathophysiological similarities of T cell and tumour necrosis factor α (TNFα) in both diseases.1,2 The MS musculoskeletal complaints masked proper assessment of his RA, resulting in a delayed diagnosis. As far as we know, this is the first case in which MS, RA, and serum anticardiolipin antibodies (aCL) have been found to be present simultaneously.

A 48 year old man presented to the orthopaedic clinic with left knee and foot pain and an associated mild weakness on the left side. Examination confirmed patellofemoral crepitus, and spastic paraparesis. A diagnosis of MS was made, supported by oligoclonal bands …