Antiphospholipid antibody syndrome presenting with disseminated bleeding and spinal subdural hemorrhage

Jayachandran, Nambiar Veettil; Rajasekhar, Liza; Narsimulu, G; Prasad, V. S. S. V.

doi:10.1038/sj.sc.3102041

Cited by 4 publications

(1 citation statement)

References 8 publications

(5 reference statements)

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“…Besides our patient presented a bleeding complication that is not a typical clinical manifestation of APS, although there are occasional reports of severe bleeding in patients affected by the disease in patients with low platelet count or with anticoagulant treatment, risk factors that were not present in our patient. It has been previously associated with spinal subdural hemorrhage, but also with a case of spontaneous epidural hematoma with multiple venous thrombi in the lower limbs [14][15][16].…”

Section: Discussionmentioning

confidence: 97%

Spinal epidural hematoma in antiphospholipid syndrome: case report and review of the literature

Guerrero-Rodriguez

Padilla-Medina

Reyes-Fernández

et al. 2022

Spinal Cord Ser Cases

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Spinal epidural hematomas are a surgical emergency, the delay in diagnosis can develop devastating sequelae due to its acute and progressive course. If not treated properly, it may lead to death or permanent neurological deficit. It is a rare condition that can occur in patients with hematologic pathology. CASE PRESENTATION: We report a case report and literature review of a patient with antiphospholipid syndrome, who undergoes a diagnostic lumbar puncture for probable fungal meningitis. Developed a spinal acute epidural hematoma with neurological involvement that is evidenced in MRI. Urgent surgical decompression was performed with good results. DISCUSSION: Despite the low incidence of an epidural hematoma in patients who undergo lumbar puncture, it is important to perform a thorough evaluation in any patient with coagulation abnormalities prior and after a lumbar puncture, by reason of the inherent possibility of developing an epidural hematoma at the site of the procedure. In the same way, early diagnosis and aggressive treatment is necessary in patients who develop progressive neurological symptoms to limit the damage and improve the prognosis for neurological recovery.

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Section: Discussionmentioning

confidence: 97%

Spinal epidural hematoma in antiphospholipid syndrome: case report and review of the literature

Guerrero-Rodriguez

Padilla-Medina

Reyes-Fernández

et al. 2022

Spinal Cord Ser Cases

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Spinal anterior epidural hematoma in an elderly man with unrecognized lupic anticoagulant taking warfarin

et al. 2011

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Spinal epidural hematoma (SEH) is a rare acute condition defined as a hematoma occurring at spinal epidural level. It is defined as "spontaneous" (SSEH) when possible causes have been ruled out; in other cases, clotting disorders and systemic lupus erythematosus have been associated with SEH. If identified rapidly, SEH can be completely cured, with complete recovery in about 50% of cases. We describe the case of an 86-year-old man affected by SEH, with rare anterior location, presenting with painful paraparesis and bladder dysfunction. The patient was taking warfarin for chronic atrial fibrillation. A prolongation of partial thromboplastin time was observed, consistent with the presence, in plasma, of previously unrecognized lupus anticoagulant antibodies (LA). The diagnosis of SEH was confirmed by MRI, and the patient was not surgically treated. Following a rehabilitation program, the patient had complete neurological recovery. Although the epidural lesion might have been a true case of SSEH, anticoagulation therapy and AL may have played a role in the pathogenesis, spread and spontaneous resolution of SEH. In cases of acute thoracic pain, associated with signs and symptoms of spinal cord compression, the diagnosis of SEH, which is a potentially devastating condition, must be carefully investigated by clinicians.

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Predictors of Outcome in Nontraumatic Spontaneous Acute Spinal Subdural Hematoma: Case Report and Literature Review

et al. 2016

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Antiphospholipid antibody syndrome presenting with disseminated bleeding and spinal subdural hemorrhage

Cited by 4 publications

References 8 publications

Spinal epidural hematoma in antiphospholipid syndrome: case report and review of the literature

Spinal epidural hematoma in antiphospholipid syndrome: case report and review of the literature

Spinal anterior epidural hematoma in an elderly man with unrecognized lupic anticoagulant taking warfarin

Predictors of Outcome in Nontraumatic Spontaneous Acute Spinal Subdural Hematoma: Case Report and Literature Review

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