Cerebral Venous Thromboembolism in Antiphospholipid Syndrome Successfully Treated with the Combined Use of an Anti-Xa Inhibitor and Corticosteroid.
Cerebral Venous Thromboembolism in Antiphospholipid Syndrome Successfully Treated with the Combined Use of an Anti-Xa Inhibitor and Corticosteroid.
复制标题
联合使用抗 Xa 抑制剂和皮质类固醇成功治疗抗磷脂综合征中的脑静脉血栓栓塞。
DOI：
10.2169/internalmedicine.54.5045
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发表时间：
2015
影响因子：
1.2
通讯作者：
H. Ichikawa
中科院分区：
文献类型：
--
作者：
M. Sugie;N. Iizuka;Y. Shimizu;H. Ichikawa
我们在此报告一个以脑静脉窦血栓形成合并原发性抗磷脂症候群为表现的病例。尽管在适当的治疗窗内使用了华法林，但患者发生了复发性CVST，随后发生出血性缺血性卒中。因此，我们用泼尼松龙替代华法林替代利伐沙班，获得了良好的临床病程。除了泼尼松龙抑制狼疮抗凝剂升高和动脉血栓形成复发的作用外，利伐沙班还可预防CVST并抑制皮质类固醇诱导的高凝状态。抗Xa抑制剂和皮质类固醇的组合可能是CVST和动脉血栓伴华法林耐药APS的替代治疗。
We herein report a case presenting with cerebral venous sinus thrombosis (CVST) associated with primary antiphospholipid syndrome (APS). The patient developed recurrent CVST followed by a hemorrhagic ischemic stroke despite the use of warfarin during the appropriate therapeutic window. Thus, we substituted warfarin to rivaroxaban with prednisolone and obtained a good clinical course. In addition to the effect of prednisolone of inhibiting elevated lupus anticoagulants and the recurrence of arterial thrombosis, rivaroxaban may prevent CVST and inhibit hypercoagulability induced by corticosteroids. The combination of an anti-Xa inhibitor and corticosteroid may be an alternative treatment for CVST and arterial thrombus with warfarin-resistant APS.