Antiphospholipid syndrome and Trousseau's syndrome
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概要
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Antiphospholipid syndrome (APS) and Trousseau's syndrome are clinically important because they are common among coagulation abnormalities as causes of cryptogenic stroke or stroke in young adults, and are treatable with antithrombotic therapy.<BR>Antiphospholipid antibodies (APLs) such as antiphosphatidyl serine or antiprothrombin antibody other than anticaldiolipin antibody or lupus anticoagulant should be measured in patients strongly suspected of APS. Disruption of annexin V shield by APLs is the first hypothesis to simultaneously explain prolongation of coagulation time and thrombophilia in APS patients. In our stroke patients with APLs, females are more common, stroke occurs earlier and preferentially involves vertebrobasilar system, and valvular heart diseases, neurological diseases, coagulation abnormalities, and venous thrombosis are frequent, but vascular risk fac-tors and large vessel lesions are less frequent, and levels of thrombin-antithrombin III complex are lower.<BR>Trousseau's syndrome is a paraneoplastic neurologic syndrome which is caused by remote effects of can-cers. Tumor cells express cellular procoagulants and fibrinolytic proteins as well as their inhibitors and recep-tors. They also release cytokines and interact with endothelial cells, monocytes and platelets to further enhance activation of coagulation cascade. Clinical characteristics of our patients with Trousseau's syndrome are at wide range of age, female-predominant, commonly associated with solid gynecological cancers, frequently suffer from multiple bland or hemorrhagic cortical infarcts, usually associated with compensated platelet counts and fibrinogen levels, and always associated with increased levels of coagulation and fibrinolysis markers.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
- Two cases with aphasia in the left putaminal damage and one case with visuospatial neglect in the right putaminal damage
- Alterations of plasma von Willebrand factor activity and the influence of anti-platelet drugs in acute cerebral infarction
- Carotid endarterectomy plaques correlation of clinical events and morphology.
- Stenting for stenosis of major cerebrovascular arteries.
- Cerebral infarction following antihypertensive therapy.