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A rare case of heparin-induced thrombocytopenia and cerebral venous sinus thrombosis with antiphospholipid syndrome and possible systemic lupus erythematosus

Ioannis Stavropoulos, Anastasios Liverezas, Eleni Papageorgiou, Sofia Tsiara

Affiliation and address for correspondence
Aktualn Neurol 2017, 17 (2), p. 121–125
DOI: 10.15557/AN.2017.0013
Abstract

Cerebral venous sinus thrombosis is a relatively rare type of stroke which can be complicated by intracerebral haemorrhage resulting often in poor prognosis. Antiphospholipid syndrome and systemic lupus erythematosus both have been associated with cerebral venous sinus thrombosis. Furthermore, a few cases combining heparin-induced thrombocytopenia with cerebral venous sinus thrombosis have been described in the literature. We present a 57-year-old female patient who was admitted reporting confusion and fever for 4 days. She was immobilized due to a thoracic vertebral fracture and received enoxaparin as a prophylaxis for deep venous thrombosis. A computed tomography scan demonstrated extensive cerebral venous sinus thrombosis and two ipsilateral haemorrhagic infarcts. Moreover, the patient was serum-positive for heparininduced thrombocytopenia antibodies and had persistent fever. A thorough immunological and serological investigation turned out consistent with antiphospholipid syndrome with possible systemic lupus erythematosus. The patient was treated accordingly and was finally discharged one month later, afebrile, with mild neurological deficits.

Keywords
cerebral venous sinus thrombosis, intracerebral haemorrhage, heparin-induced thrombocytopenia, antiphospholipid syndrome, systemic lupus erythematosus

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