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Recurrent strokes and memory loss in a patient with triple-positive antiphospholipid antibody syndrome
  1. Chinenye Osuorji1,
  2. Jawad Bilal2 and
  3. Ikenna Osuorji3
  1. 1Internal Medicine, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, USA
  2. 2Rheumatology, University of Arizona, Tucson, Arizona, USA
  3. 3Haematology/Oncology, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, USA
  1. Correspondence to Dr Chinenye Osuorji; COSUORJI2012{at}GMAIL.COM

Abstract

Antiphospholipid syndrome may cause recurrent thromboembolic events of the microvasculature, arteries and veins. It is also characterised by a range of neurological and psychiatric dysfunctions, as well as complications during pregnancy. Patients with triple-positive antiphospholipid syndrome have persistently elevated levels of lupus anticoagulant (LA), anti-beta-2-glycoprotein I (B2GPI) and anticardiolipin antibodies (aCL). These patients also have a higher risk of initial or recurrent thrombosis.

We report the case of a 36-year-old man who was presented with progressive memory loss and recurrent stroke. He had persistently elevated antiphospholipid antibody titres (LA, aCL-immunoglobulin G and B2GPI antibodies). These features persisted while the patient was receiving low-dose aspirin (LDA), 81mg daily. Vitamin K antagonist (VKA); warfarin, with the international normalised ratio (INR) maintained at 2–3 was then added to his treatment regimen. The VKA dose was maintained at - a higher therapeutic INR while LDA administration was continued to achieve resolution of the patient’s symptoms.

  • venous thromboembolism
  • malignant and benign haematology
  • memory disorders
  • warfarin therapy

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Footnotes

  • Contributors All the authors (IO, JB, CO) listed in this paper contributed substantially to the conception, design and development of this manuscript. IO, CO contributed extensively to drafting this paper, data collection, analysis and literature review. JB, CO contributed substantially to the critical analysis and review of the intellectual content of this paper. IO is the guarantor and contributed substantially to the final approval of the version to be published. IO, JB, CO are accountable for the accuracy and integrity of the manuscript. CO, JB, IO were involved in the final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.