Van Dick-Sánchez MP, Sanroman-Tovar RA, Gallardo-Meza FA

Language: Spanish
References: 10
Page: 167-172
PDF size: 377.08 Kb.

ABSTRACT

The ischemic cerebral vascular event secondary to antiphospholipid syndrome occurs due to an endothelial damage associated with autoimmune disorders. We present the case of a 12-year-old female patient who went to the emergency room due to deterioration in the state of alertness and right hemiparesis. Th e magnetic resonance showed initially infarction in the territory of the left middle cerebral artery. A transthoracic echocardiogram showed vegetation in the mitral valve. Serological tests for antiphospholipid syndrome were positive. Objective: To describe the case of a 12-year-old adolescent patient with primary antiphospholipid syndrome manifested as an ischemic cerebrovascular event with catastrophic consequences. Methodology: Case report and review of bibliography related to the main pathologies. Conclusion: Is very important the recognition and management of these patients, with anticoagulation based on low molecular weight heparin, with constant measurement of INR (internationalized normalized ratio) to assess eff ectiveness, with constant evaluation of the patient, reduction of morbidity and subsequent mortality.

REFERENCES

1. Nunes T, Recalde L, Espínola de Canata M. Characteristics of Cerebrovascular Accidents (CVA) in Children. Pediatr. (Asunción), Vol. 35; No 1; 2008.

2. Margherita Rosa, Silvana De Lucia, Victoria Elisa Rinaldi, Julie Le Gal, Marie Desmarest, Claudio Veropalumbo, Silvia Romanello and Luigi Titomanlio. . Paediatric arterial ischemic stroke: acute management, recent advances and remaining issues. Italian Journal of Pediatrics (2015) 41:95 DOI 10.1186/ s13052-015-0174-y

3. E. Muscal, R.L. Brey. Antiphospholipid Syndrome and the Brain in Pediatric and Adult Patients. Lupus. 2010 April ; 19(4): 406– 411. doi:10.1177/0961203309360808.

4. María Belén Nallino, Adriana Ojeda, Ana María Uriarte. Stroke isquémico en pacientes jóvenes: un desafío diagnóstico. RAR - Volumen 75 - Numero 2 – 2011: 55-59

5. Ali Nayer, Luis M. Ortega. Catastrophic antiphospholipid syndrome: a clinical review . J Nephropathol. 2014; 3(1): 9-17. DOI: 10.12860/jnp.2014.03

6. Avčin, T. and Kathleen M., O. (2011). Antiphospholipid Syndrome. In: J. Cassidy, R. Petty, R. Laxer and C. Lindsley, ed., TEXTBOOK OF Pediatric Rheumatology, 6th ed. Philadelphia: Saunders Elsevier, pp.344-360.

7. Amelie-Lefond Catherine. Evaluation and Acute Management of Ischemic Stroke in Infants and Children. CONTINUUM (MINNEAP MINN) 2018;24(1, CHILD NEUROLOGY): 150– 170.

8. Gonzalez A., Vergara M., Heredia A., et al. Accidente cerebrovascular embólico por endocarditis de Libman-Sacks como manifestación inicial de síndrome antifosfolípidos primario en una paciente de 17 años. Rev Med chile 2013; 141: 1206-1210

9. Ruiz-Irastorza G, Cuadrado MJ, Ruiz-Arruza I, Brey R, Crowther M, Derksen R, et al. Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th International Congress on antiphospholipid antibodies. Lupus 2011; 20 (2): 206-18.

10. Tripodi A, de Groot PG, Pengo V. Antiphospholipid syndrome: laboratory detection, mechanisms of action and treatment. J Intern Med 2011 Aug; 270 (2): 110-22.