Profile of 26 HIV Seropositive individuals with Cerebral Venous Thrombosis

Netravathi, M; Jaychandran, R; Bhat, Maya; Christopher, Rita; Satishchandra, P

doi:10.1016/j.jns.2017.04.034

Cited by 8 publications

(4 citation statements)

References 24 publications

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“…29 Numerous viral infections are associated with coagulopathy. [8][9][10][30][31][32] Direct or indirect activation of endothelial cells by viruses may impair coagulation and the fibrinolytic systems. Moreover, antiphospholipid antibodies can be identified in several viral infections, including cytomegalovirus, HIV, and varicella zoster virus, [8][9][10] also in immunocompetent patients.…”

Section: Hypercoagulable State In Other Scenariosmentioning

confidence: 99%

“…9 A hypercoagulable state is well-known among patients with human herpes viruses (DNA viruses) and HIV. [8][9][10]30,32 Chronic HIV infection has been associated with up to a 10-fold increased risk of venous thrombosis. 8 Finally, microvascular thrombosis was seen in a specific transgenic mouse model, used in studying the Middle East respiratory syndrome coronavirus infection.…”

Section: Hypercoagulable State In Other Scenariosmentioning

confidence: 99%

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Cerebral Venous Thrombosis Associated with COVID-19

Cavalcanti¹,

Raz²,

Shapiro³

et al. 2020

AJNR Am J Neuroradiol

225

232

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Despite the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. We report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. Three patients younger than 41 years of age with confirmed Severe Acute Respiratory Syndrome coronavirus 2 (SARS-Cov-2) infection had neurologic findings related to cerebral venous thrombosis. They were admitted during the short period of 10 days between March and April 2020 and were managed in an academic institution in a large city. One patient had thrombosis in both the superficial and deep systems; another had involvement of the straight sinus, vein of Galen, and internal cerebral veins; and a third patient had thrombosis of the deep medullary veins. Two patients presented with hemorrhagic venous infarcts. The median time from COVID-19 symptoms to a thrombotic event was 7 days (range, 2-7 days). One patient was diagnosed with new-onset diabetic ketoacidosis, and another one used oral contraceptive pills. Two patients were managed with both hydroxychloroquine and azithromycin; one was treated with lopinavirritonavir. All patients had a fatal outcome. Severe and potentially fatal deep cerebral thrombosis may complicate the initial clinical presentation of COVID-19. We urge awareness of this atypical manifestation.ABBREVIATIONS: COVID-19 ¼ coronavirus disease 2019; CVT ¼ cerebral venous thrombosis; RT-PCR ¼ real-time reverse transcriptase polymerase chain reaction; SARS-CoV2 ¼ Severe Acute Respiratory Syndrome-coronavirus 2 A novel Severe Acute Respiratory Syndrome-coronavirus 2 (SARS-CoV2) was identified on January 7, 2020, by the Chinese Center for Disease Control and Prevention from a nasopharyngeal swab in a patient with atypical pneumonia in Wuhan, Hubei province, China. 1 The mortality rate of critically ill patients with COVID-19 is high. As of May 13, 2020, more than 1.4 million individuals had tested positive for the SARS-CoV2 in the United States, leading to .84,000 deaths. Acute cardiac injury, acute kidney injury, and precipitous thromboembolic events have been increasingly reported and may develop irrespective of pulmonary or respiratory symptoms at presentation. [1][2][3][4][5] Recent studies have reported the potential development of a hypercoagulable state in COVID-19. 2,3,6,7 Viral infections may promote dysfunction of endothelial cells, leading to excess thrombin

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Section: Hypercoagulable State In Other Scenariosmentioning

confidence: 99%

Section: Hypercoagulable State In Other Scenariosmentioning

confidence: 99%

Cerebral Venous Thrombosis Associated with COVID-19

Cavalcanti¹,

Raz²,

Shapiro³

et al. 2020

AJNR Am J Neuroradiol

225

232

View full text Add to dashboard Cite

show abstract

“…Chronic HIV infection increases the risk of developing a deep veinous thrombosis even when infection is controlled. Pro-inflammatory state, decreased anticoagulant mechanisms, increased procoagulant factor, related immunodeficiency state and protease inhibitor may contribute to thrombotic events in HIV patients (16,17). Noticeably, sinus thrombosis in HIV patients is paucisymptomatic and affects mostly superior sagittal and lateral sinus thrombosis (17).…”

Section: Discussionmentioning

confidence: 99%

“…Pro-inflammatory state, decreased anticoagulant mechanisms, increased procoagulant factor, related immunodeficiency state and protease inhibitor may contribute to thrombotic events in HIV patients (16,17). Noticeably, sinus thrombosis in HIV patients is paucisymptomatic and affects mostly superior sagittal and lateral sinus thrombosis (17). We decided to initiate Dabigatran on the basis of recent randomized study (18).…”

Section: Discussionmentioning

confidence: 99%

CSF HIV RNA Escape in Opsoclonus-Myoclonus-Ataxia Syndrome: Case Report and Review of the Literature

et al. 2020

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Background: Human immunodeficiency viruses (HIV) infection is associated with a broad range of neurological manifestations, including opsoclonus-myoclonus ataxia syndrome (OMAS) occurring in primary infection, immune reconstitution syndrome or in case of opportunistic co-infection.Case: We report the exceptional case of a 43-year-old female under HIV treatment for 10 years who presented initially with suspected epileptic seizure. Although the clinical picture slightly improved under anti-epileptic treatment, it was rapidly attributed to OMAS. The patient exhibited marked opsoclonus, mild dysarthria, upper limbs intermittent myoclonus, ataxia in 4 limbs, truncal ataxia, and a severe gait ataxia (SARA score: 34). The diagnostic work-up showed radiological and biological signs of central nervous system (CNS) inflammation and cerebral venous sinus thromboses. The HIV viral load was higher in cerebrospinal fluid (CSF) than in the blood (4,560 copies/ml vs. 76 copies/ml). She was treated for 5 days with pulsed corticotherapy. Dolutegravir and anticoagulation administration were initiated. Follow-ups at 2 and 4 months showed a dramatic improvement of clinical neurologic status (SARA score at 4 months: 1), reduction of CNS inflammation and revealed undetectable CSF and serum viral loads.Conclusion: This case underlines the importance of the evaluation of the CSF viral load in HIV patients developing OMAS and suggests CSF HIV RNA escape as a novel cause for OMAS.

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Venous thromboembolism in viral diseases: A comprehensive literature review

Zerangian

Erabi

Poudineh

et al. 2023

Health Science Reports

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Venous thromboembolism (VTE) is known to be a common respiratory and/or cardiovascular complication in hospitalized patients with viral infections. Numerous studies have proven human immunodeficiency virus infection to be a prothrombotic condition. An elevated VTE risk has been observed in critically ill H1N1 influenza patients. VTE risk is remarkably higher in patients infected with the Hepatitis C virus in contrast to uninfected subjects. The elevation of D‐dimer levels supported the association between Chikungunya and the Zika virus and the rise of clinical VTE risk. Varicella‐zoster virus is a risk factor for both cellulitis and the consequent invasive bacterial disease which may take part in thrombotic initiation. Eventually, hospitalized patients infected with the coronavirus disease of 2019 (COVID‐19), the cause of the ongoing worldwide pandemic, could mainly suffer from an anomalous risk of coagulation activation with enhanced venous thrombosis events and poor quality clinical course. Although the risk of VTE in nonhospitalized COVID‐19 patients is not known yet, there are a large number of guidelines and studies on thromboprophylaxis administration for COVID‐19 cases. This study aims to take a detailed look at the effect of viral diseases on VTE, the epidemiology of VTE in viral diseases, and the diagnosis and treatment of VTE.

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Profile of 26 HIV Seropositive individuals with Cerebral Venous Thrombosis

Cited by 8 publications

References 24 publications

Cerebral Venous Thrombosis Associated with COVID-19

Cerebral Venous Thrombosis Associated with COVID-19

CSF HIV RNA Escape in Opsoclonus-Myoclonus-Ataxia Syndrome: Case Report and Review of the Literature

Venous thromboembolism in viral diseases: A comprehensive literature review

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