TY - JOUR T1 - Catastrophic cerebral antiphospholipid syndrome presenting as cerebral infarction with haemorrhagic transformation after sudden withdrawal of warfarin in a patient with primary antiphospholipid syndrome JF - BMJ Case Reports DO - 10.1136/bcr.09.2009.2243 VL - 2010 SP - bcr0920092243 AU - Abdul Majid Wani AU - Waleed Mohd Hussain AU - Mousa Ali Al Mejally AU - Khaled Shawkat Ali AU - Sadeya Hanif Raja AU - Wael Al Maimani AU - Mazen G Bafaraj AU - Ashraf Bashraheel AU - Mubeena Akhtar AU - Amer Mohd Khoujah Y1 - 2010/01/01 UR - http://casereports.bmj.com/content/2010/bcr.09.2009.2243.abstract N2 - Catastrophic antiphospholipid syndrome (APS) is caused by thrombotic vascular occlusions that affect both small and large vessels, producing ischaemia in the affected organs. The “catastrophic” variant of the antiphospholipid syndrome (cAPS) develops over a short period of time. Although patients with cAPS represent <1% of all patients with APS, they are usually life threatening with a 50% mortality rate. A strong association with concomitant infection is thought to act as the main trigger of microthromboses in cAPS. Several theories have been proposed to explain these physiopathological features. Some of them suggest the possibility of molecular mimicry between components of infectious microorganisms and natural anticoagulants, which might be involved in the production of cross-reacting antiphospholipid antibodies. We present a case of catastrophic cerebral APS characterised by massive temporal lobe infarction and subsequent haemorrhagic transformation after sudden withdrawal of warfarin. ER -