PT  - JOURNAL ARTICLE
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
TI  - Catastrophic cerebral antiphospholipid syndrome presenting as cerebral infarction with haemorrhagic transformation after sudden withdrawal of warfarin in a patient with primary antiphospholipid syndrome
AID  - 10.1136/bcr.09.2009.2243
DP  - 2010 Jan 01
TA  - BMJ Case Reports
PG  - bcr0920092243
VI  - 2010
4099  - http://casereports.bmj.com/content/2010/bcr.09.2009.2243.short
4100  - http://casereports.bmj.com/content/2010/bcr.09.2009.2243.full
AB  - 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.