Cerebral venous thrombosis due to cryptogenic organising pneumopathy with antiphospholipid syndrome worsened by heparin-induced thrombocytopenia

Abstract

Cerebral venous thrombosis (CVT) has usually been ascribed to prothrombotic conditions, oral contraceptives, pregnancy, malignancy, infection, head injury or mechanical precipitants. The case reported here illustrates two rare causes of CVT observed in the same patient: the presence of antiphospholipid antibodies associated with an asymptomatic cryptogenic organising pneumopathy (COP) which were considered the origin of the venous cerebral thrombosis and heparin-induced thrombocytopenia (HIT) which was responsible for the worsening of the thrombosis observed a few days after the introduction of treatment. Moreover, we provide here additional positive experience in the treatment of both, CVT and HIT, by fondaparinux with bridging to warfarin given their successful evolution under this anticoagulant option.

Lupus, antiphospholipid syndrome, and stroke: An attempt to crossmatch

“…Shlebak 128 IgG Transverse sinus, sigmoid sinus Warfarin Shlebak 128 IgG Transverse sinus Warfarin Behrendt et al 129 IgM and IgG Superior sagittal sinus, right transverse sinus Warfarin, venticuloperitoneal shunt Pelegrina Molina et al 130 IgG Superior sagittal sinus, right transverse sinus Warfarin, corticosteroids Nagai et al 131 Unspecified Superior sagittal sinus, cortical vein Corticosteroids Miki et al 132 Unspecified Straight sinus Anticoagulation Ikejiri et al 133 IgG Right transverse sinus NR Numata et al 134 Unspecified Cortical vein Therapeutic heparin Hsieh et al 135 IgM Superior sagittal sinus, right transverse sinus Warfarin, corticosteroids Sakamoto et al 136 Unspecified Superior sagittal sinus Warfarin brain small vessels leading to inflammatory vascular occlusion. 79 Despite that SLE is characterized by low complement levels, elevated complement levels were associated with stroke.…”

Successful endovascular therapy for cerebral venous sinus thrombosis accompanied by heparin-induced thrombocytopenia

“…12 Because of sparsity of each pathology, a limited number of cases involving both CVST and secondary HIT have been reported. [13][14][15] Here, we report the first reported case, to our best knowledge, of CVST accompanied by HIT during the clinical course which was successfully treated by endovascular therapy (EVT) in combination with argatroban instead of heparin.…”