Unusual thrombotic manifestations secondary to antiphospholipid syndrome and hepatic fascioliasis

Neurological and Ocular Fascioliasis in Humans

“…An axillary-subclavian deep venous thrombosis, clearly distended superficial veins, pain and swelling of the left arm, and an acute cerebrovascular stroke were associated with F. hepatica infection in an apraxic old woman (Linares et al, 2006).…”

“…Other interesting guiding results found in the analyses of patients with major neurological manifestations include an increased erythrocyte sedimentation rate (usually present), high to very high levels of serum IgE (Berenger, 1984;Cames et al, 1947;Park and Sohn, 2010), high prothrombin rate (Domart et al, 1971;Gil et al, 1970;Lefevre et al, 1970), and shortening of the partial thromboplastin time (Linares et al, 2006). Indicators that should be emphasized due to their potential special significance are a high circulating immune complexes rate (Aimard et al, 1984;Auer et al, 1982;Kristoferitsch et al, 1982), elevated level of C-reactive protein (Murase et al, 1998;Paraf et al, 1967;Park and Sohn, 2010), and positivity to antiphospholipid antibodies with anticardiolipin antibody IgG (Frances et al, 1994;Linares et al, 2006;Oujama et al, 2003;Pelletier et al, 1995).…”

“…Another curious manifestation is a motor incoordination condition of the impossibility to remain seated (Domart et al, 1967), similarly as the apraxic condition of a female patient who began to get dressed and to undress with some difficulty, to get into the bed, or to sit down in a seat (Linares et al, 2006). (D) Paraesthesia: Such a condition has been described in several fascioliasis patients, affecting different parts of the body.…”

“…On the contrary, it showed small hypodense central areas bilaterally and also in the left frontal region . Similarly, hypodensity was also revealed in the right subcortical frontal lobe by brain CT scan (Linares et al, 2006). CT was used to confirm a meningeal haemorrhage with the presence of blood in the lateral ventricles and cortical folds (case 1 of Berenger, 1984).…”

“…(F) Other additional techniques: Other observations included a normal pneumoencephalography in a patient (Coulaud et al, 1970), a normal myelogram in one case of sciatica , and an electromyography showing signs of peripheral neurogenic affection with slowdown of the motor conduction speed in a patient in whom an areflexia of the four limbs occurred (Aimard et al, 1984). A cervical Doppler ultrasonography helped in identifying a thrombosis located in the left subclavian and axillary veins (Linares et al, 2006). Although neuroimaging techniques have so far shown the absence of specific characteristics common to neurological patients, the combination of EEG with brain imaging techniques may pronouncedly help in the diagnosis and management of fascioliasis patients with neurological manifestations.…”