QJM Advance Access originally published online on May 12, 2008
QJM 2008 101(7):591; doi:10.1093/qjmed/hcn063
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The hidden anti-phospholipid antibody syndrome
Sir,Kalita and colleagues report three interesting cases of women with cerebral venous sinus thrombosis leading to intracerebral haemorrhage.1 However, they cited that the underlying conditions could not be identified, I disagree. The authors performed prothrombotic screenings but failed to include anti-phospholipid antibody syndrome (APS) among other differentials. These are common disorders, which might be the hidden causes in the patients2 And cerebral venous sinus thrombosis is a well known complication of such disorder.3,4 I believe that anti-cardiolipin antibodies and lupus anticoagulant must be screened in the authors patients.
Last but not least, APS must be detected for any unknown hypercoagulable states.
Surin Hospital
Surin 32000
Thailand
email: weekitti{at}gmail.com
References
1. Kalita J, Bansal V, Misra UK, Jain SK. Intracerebral haemorrhage due to cerebral venous sinus thrombosis. Q J Med (2008) 101:247–9.[Web of Science]
2. Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med (2002) 346:752–63.
3. Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med (2005) 352:1791–8.
4. Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol (2007) 6:162–70.[CrossRef][Web of Science][Medline]
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