Late-onset of primary antiphospholipid syndrome: a case report
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LETTER TO THE EDITOR
Late‑onset of primary antiphospholipid syndrome: a case report Adam Benkirane1 · Bérangère Devalet2 · Pauline Montigny3 · Frédéric London1 Received: 21 September 2020 / Accepted: 12 November 2020 © Belgian Neurological Society 2020
Introduction Antiphospholipid syndrome (APS) is a rare autoantibodymediated acquired disorder characterized by thrombotic events and/or obstetrical morbidities, with persistent antiphospholipid (aPL) antibodies (Abs) [1]. Its diagnosis requires persistent positivity in at least one of three aPL tests conducted on two or more occasions at least 12 weeks apart [1]. APS is likely to be diagnosed in early adulthood and is far more common in women [2, 3]. Onset of APS over the age of 50 is however rare [4]. Here, we describe a case of late-onset of triple-positive primary APS.
Case presentation An 83-year-old woman was admitted to our institution after she suddenly developed left-sided faciobrachial weakness and numbness > 6 h before admission. The initial National Institutes of Health Stroke Scale (NIHSS) score was 3. The patient was afebrile on admission with a blood pressure of 157/86 mm Hg and regular heart rate of 67. Identified stroke risk factors included smoking, hypertension, and dyslipidemia. Her medical history was remarkable for lacunar stoke and mesenteric ischemia 13 and 2 years ago respectively. She denied a history of spontaneous abortions or pulmonary embolism but had recurrent deep venous thrombosis history over the age of 70. There was no history of recent vaccine administration or malignancy. Urgent brain MRI showed acute ischemia involving subcortical areas of the * Frédéric London [email protected] 1
Department of Neurology, Université Catholique de Louvain (UCLouvain), CHU UCL Namur, 1 Avenue G. Thérasse, B‑5530 Yvoir, Belgium
2
Department of Hematology, Université Catholique de Louvain (UCLouvain), CHU UCL Namur, Yvoir, Belgium
3
Department of Rheumatology, Université Catholique de Louvain (UCLouvain), CHU UCL Namur, Yvoir, Belgium
right central sulcus (right middle cerebral artery territory). Computed tomography angiography showed diffuse carotid atherosclerosis but no vessel stenosis nor occlusion. Electrocardiogram and transthoracic echocardiography were normal. Atrial fibrillation was not detected. Routine blood tests were normal, except for high cholesterol level (total cholesterol 218 mg/dL, LDL 152 mg/dL). C-ReactiveProtein was 3.3 mg/L (N 200 U MPL/mL; N
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