Talks
Academic Level (Author 1)
Resident
Discipline/Specialty (Author 1)
Internal Medicine
Discipline/Specialty (Author 2)
Internal Medicine
Discipline/Specialty (Author 3)
Internal Medicine
Discipline/Specialty (Author 4)
Internal Medicine
Discipline Track
Patient Care
Abstract
Background: Anti-phospholipid syndrome (APS) is an autoimmune disorder characterized by venous and arterial thrombosis, usually in setting of underlying autoimmune disorders. Here, we present a case of anti-phospholipid syndrome post covid infection.
Case Presentation: 41-year-old lady presented to the ER with complaints of left sided facial droop for 3-day duration. On further evaluation, she was found to have subacute ischemic stroke and was managed with anticoagulation and supportive treatment. Past medical history is significant for a recent diagnosis of Covid infection and for subsequent development of lower extremity deep vein thrombosis (DVT). She was started on anticoagulation with rivaroxaban for the DVT. However, anticoagulation had to be held due to hemorrhagic transformation of the ischemic stroke. Further work up for young stroke revealed having elevated PTT, elevated titers for anticardiolipin Ab IgG and IgM, positive lupus anticoagulant by screen and confirmatory tests leading to diagnosis of APS. She was readmitted a few days later for acute DVT of left lower extremity and underwent thrombectomy. Warfarin was initiated to bridge from heparin in setting of acquired anti-phospholipid syndrome. The goal INR 2.5-3.5 was reached uneventfully, and she was discharged home.
Conclusions: In Anti-phospholipid syndrome, patients typically have a history of multiple pregnancy loss and underlying autoimmune disorders. Our patient has no typical risk factors for anti-phospholipid syndrome and is likely triggered by covid infection. Acquired APS in setting of recent covid infection needs to be considered in the setting of recurrent thrombotic events.
Presentation Type
Talk
Recommended Citation
Kolli, Himabindu; Maknoor, Pooja; Rajan, Celin; and Varghese, Nevin, "COVID-19 as a second hit for Anti-phospholipid syndrome" (2023). Research Colloquium. 1.
https://scholarworks.utrgv.edu/colloquium/2022/talks/1
Included in
Allergy and Immunology Commons, Critical Care Commons, Hematology Commons, Infectious Disease Commons, Internal Medicine Commons, Neurology Commons, Preventive Medicine Commons, Primary Care Commons
COVID-19 as a second hit for Anti-phospholipid syndrome
Background: Anti-phospholipid syndrome (APS) is an autoimmune disorder characterized by venous and arterial thrombosis, usually in setting of underlying autoimmune disorders. Here, we present a case of anti-phospholipid syndrome post covid infection.
Case Presentation: 41-year-old lady presented to the ER with complaints of left sided facial droop for 3-day duration. On further evaluation, she was found to have subacute ischemic stroke and was managed with anticoagulation and supportive treatment. Past medical history is significant for a recent diagnosis of Covid infection and for subsequent development of lower extremity deep vein thrombosis (DVT). She was started on anticoagulation with rivaroxaban for the DVT. However, anticoagulation had to be held due to hemorrhagic transformation of the ischemic stroke. Further work up for young stroke revealed having elevated PTT, elevated titers for anticardiolipin Ab IgG and IgM, positive lupus anticoagulant by screen and confirmatory tests leading to diagnosis of APS. She was readmitted a few days later for acute DVT of left lower extremity and underwent thrombectomy. Warfarin was initiated to bridge from heparin in setting of acquired anti-phospholipid syndrome. The goal INR 2.5-3.5 was reached uneventfully, and she was discharged home.
Conclusions: In Anti-phospholipid syndrome, patients typically have a history of multiple pregnancy loss and underlying autoimmune disorders. Our patient has no typical risk factors for anti-phospholipid syndrome and is likely triggered by covid infection. Acquired APS in setting of recent covid infection needs to be considered in the setting of recurrent thrombotic events.