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Rare case of catastrophic antiphospholipid syndrome with spontaneous intracranial haemorrhage
- Source :
- BMJ Case Rep
- Publication Year :
- 2019
-
Abstract
- Catastrophic antiphospholipid syndrome (CAPS) is a rare but severe form of antiphospholipid syndrome (APS). The syndrome manifests itself as a rapidly progressive multiorgan failure that is believed to be caused by widespread micro-thrombosis. Seldom does bleeding comanifest with thrombosis. We present a patient with APS who presented with nausea, vomiting and fatigue, and rapidly progressed into multiorgan failure before being diagnosed with CAPS. The clinical course was complicated by an atraumatic intracranial haemorrhage which demanded discontinuation of anticoagulation. The patient was treated with high dose steroid, intravenous immunoglobulin, followed by weekly rituximab infusion. Although the trigger for CAPS was not obvious during her hospital stay, she was diagnosed with acute cytomegalovirus (CMV) infection soon after discharge. In this case report, we explore the differential diagnoses of CAPS, investigate the possibility of CMV infection as a potential trigger, present the therapeutic challenges of anticoagulation and discuss the emerging use of rituximab.
- Subjects :
- Adult
Pediatrics
medicine.medical_specialty
Nausea
Congenital cytomegalovirus infection
030204 cardiovascular system & hematology
Catastrophic antiphospholipid syndrome
Diagnosis, Differential
03 medical and health sciences
0302 clinical medicine
Antiphospholipid syndrome
Rare Disease
medicine
Humans
Catastrophic Illness
030203 arthritis & rheumatology
business.industry
Immunoglobulins, Intravenous
General Medicine
medicine.disease
Antiphospholipid Syndrome
Thrombosis
Magnetic Resonance Imaging
Discontinuation
Vomiting
Rituximab
Female
medicine.symptom
business
Intracranial Hemorrhages
medicine.drug
Subjects
Details
- ISSN :
- 1757790X
- Volume :
- 12
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- BMJ case reports
- Accession number :
- edsair.doi.dedup.....a1a127c36d6fa962754fe794ba9c2172