11 December 2019
: Case report
Primary Antiphospholipid Antibody Syndrome Complicated with Cerebellar Hemorrhage and Aortic Dissection: A Case Report
Diagnostic / therapeutic accidents, Management of emergency care, Rare coexistence of disease or pathology
Yoshio Tatsuoka1ABCDEF*, Yui Mano1ABCDE, Shuichi Ishikawa1CDEF, Shigeru Shinozaki2ABCDEFDOI: 10.12659/AJCR.919649
Am J Case Rep 2019; 20:1852-1856
Abstract
BACKGROUND: Antiphospholipid antibody syndrome (APS) is a systemic autoimmune disease associated with arterial and venous thromboembolism and pregnancy complications. There have been several reports of APS with systemic lupus erythematosus (SLE) complicated with aortic dissection. However, none of them has been primary APS, which is APS without SLE.
CASE REPORT: A 42-year-old woman with primary APS and APS nephropathy on warfarin and aspirin therapy presented with coma due to cerebellar hemorrhage. The effect of warfarin was immediately reversed with prothrombin complex concentrate. We performed emergent evacuation of the hematoma, and her level of consciousness improved to normal on postoperative day (POD) 1. She had acute hypertension on arrival, which was resistant to multiple antihypertensives and was stabilized on POD 3. She also had exacerbation of chronic kidney disease after using contrast and prothrombin concentrate complex, and was on temporary renal replacement therapy from POD 3. Aortic dissection was found accidentally on echocardiography on POD 7, and she was subsequently treated medically. She was transferred to the rehabilitation hospital with mild dysarthria and truncal ataxia on POD 59.
CONCLUSIONS: We report the first case in the English literature of primary APS complicated with cerebellar hemorrhage and aortic dissection. Acute hypertension following hemorrhage and exacerbation of APS nephropathy likely triggered the dissection of the aortic wall, the integrity of which might have been compromised by longstanding antiphospholipid antibody and vasa vasorum thrombosis.
Keywords: Antiphospholipid Syndrome, Aortic Diseases, Intracranial Hemorrhages, Adult, Aneurysm, Dissecting, Cerebellar Diseases, Coma, Hypertension, Renal Insufficiency, Chronic
SARS-CoV-2/COVID-19
19 May 2022 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936370
17 May 2022 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936651
13 May 2022 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936589
13 May 2022 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936574
In Press
20 May 2022 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936826
19 May 2022 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936252
19 May 2022 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936318
19 May 2022 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936377
Most Viewed Current Articles
31 Dec 1969 : Case report
DOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250
31 Dec 1969 : Case report
DOI :10.12659/AJCR.934399
Am J Case Rep 2022; 23:e934399
31 Dec 1969 : Case report
DOI :10.12659/AJCR.934406
Am J Case Rep 2021; 22:e934406
31 Dec 1969 : Case report
DOI :10.12659/AJCR.935355
Am J Case Rep 2022; 23:e935355