A clinical observation is presented of a young patient with a rare form of homozygous mutation, which caused recurrent pulmonary embolism, ischemic stroke in the left middle cerebral artery basin. To determine the etiology of recurrent thrombosis, instrumental diagnostic methods were performed to exclude dissection of extra- and intracranial arteries, heart diseases, as well as laboratory methods to detect thrombophilia, antiphospholipid syndrome, connective tissue diseases, and the blood system. According to the results of the examination, the patient revealed a homozygous mutation of the plasminogen activator inhibitor PAI-1, which, in the absence of other factors, can be considered as a probable cause of recurrent thrombosis. During treatment, the patients condition improved, focal neurological symptoms partially regressed. As a secondary prophylaxis, the patient was prescribed lifelong administration of warfarin under the control of INR.
The clinical case presents a young patient with antiphospholipid syndrome, which was the cause of recurrent acute ischemic cerebrovascular accidents and pathology of pregnancy.
During the clinical and laboratory examination, the patient was diagnosed with systemic lupus erythematosus. To determine the etiology of ischemic strokes and recurrent pregnancy loss, the patient underwent an immunological blood test which led to diagnosing the antiphospholipid syndrome. The patient failed to comply with the doctor's recommendations for taking an anticoagulant in the early postpartum period that resulted in the development of multifocal ischemic stroke.
After treatment, the patient's condition improved, focal neurological symptoms partially regressed, and laboratory parameters returned to normal. As a secondary prevention of thrombosis, the patient was prescribed anticoagulant therapy.
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