The antiphospholipid antibody syndrome is a disorder characterised by the production of autoantibodies directed against negatively charged cell membrane phosholipids. Antiphospholipid antibodies have been described in various neurological disorders.

It has been generally accepted that viral, bacterial, and parasitic infections can serve as a trigger factor for autoimmune reactions. Despite the growing knowledge that has accumulated, the relation between parasites and autoimmunity has not been clarified.

Enterobius vermicularis (pinworm) is a nematode rarely found outside the gastrointestinal tract, but allergic reaction due to enterobiasis has been reported.1 We describe the case of transverse myelopathy preceded by intestinal pinworm infestation in the primary antiphospholipid antibody syndrome. To our knowledge, such an association has not been reported previously. Pinworm therapy was complicated by the Jarisch-Herxheimer reaction manifested by temporary exacerbation of pre-existing neurological symptoms.

In March 1998, a 40 year old woman who complained of perianal itching noticed the presence of worms migrating from the anus. Three days later itching and numbness involved both legs, and the patient had weakness in the legs. These symptoms progressed over the next 3 days to severe paraparesis and urinary urgence. Her medical history was relevant for three unexplained miscarriages …