Open AccessCatastrophic cerebral antiphospholipid syndrome presenting as cerebral infarction with haemorrhagic transformation after sudden withdrawal of warfarin in a patient with primary antiphospholipid syndrome
Author(s) -
Abdul Majid Wani,
Waleed Mohd Hussain,
Mousa Ali Al Mejally,
Khaled Shawkat Ali,
Sadeya Hanif Raja,
Wael Al Maimani,
Mazen G Bafaraj,
Ashraf Bashraheel,
Mubeena Akhtar,
Amer Mohd Khoujah
Publication year - 2010
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.09.2009.2243
Subject(s) - catastrophic antiphospholipid syndrome , medicine , antiphospholipid syndrome , warfarin , catastrophic illness , cardiology , thrombosis , atrial fibrillation
Catastrophic antiphospholipid syndrome (APS) is caused by thrombotic vascular occlusions that affect both small and large vessels, producing ischaemia in the affected organs. The "catastrophic" variant of the antiphospholipid syndrome (cAPS) develops over a short period of time. Although patients with cAPS represent <1% of all patients with APS, they are usually life threatening with a 50% mortality rate. A strong association with concomitant infection is thought to act as the main trigger of microthromboses in cAPS. Several theories have been proposed to explain these physiopathological features. Some of them suggest the possibility of molecular mimicry between components of infectious microorganisms and natural anticoagulants, which might be involved in the production of cross-reacting antiphospholipid antibodies. We present a case of catastrophic cerebral APS characterised by massive temporal lobe infarction and subsequent haemorrhagic transformation after sudden withdrawal of warfarin.