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Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus

We present a case of a 21-year-old African-American female with no significant medical history, who presented to the emergency department with a one-week history of blurry and double vision. Ophthalmology evaluation revealed bilateral retinal artery occlusion. Further workup with imaging of the brai...

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Autores principales: Khan, Reshma M., Namas, Rajaie, Parikh, Sachin, Rubin, Bernard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525759/
https://www.ncbi.nlm.nih.gov/pubmed/26266073
http://dx.doi.org/10.1155/2015/373201
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author Khan, Reshma M.
Namas, Rajaie
Parikh, Sachin
Rubin, Bernard
author_facet Khan, Reshma M.
Namas, Rajaie
Parikh, Sachin
Rubin, Bernard
author_sort Khan, Reshma M.
collection PubMed
description We present a case of a 21-year-old African-American female with no significant medical history, who presented to the emergency department with a one-week history of blurry and double vision. Ophthalmology evaluation revealed bilateral retinal artery occlusion. Further workup with imaging of the brain was consistent with an ischemic stroke. Hereditary hypercoagulable workup was unremarkable and initial testing for antiphospholipid syndrome was positive. She underwent transesophageal echocardiogram (TEE), which showed severe mitral regurgitation and thickening of mitral valve leaflets consistent with Libman-Sacks endocarditis. Autoimmune workup was positive for IF-ANA, anti-RNP, and anti-Smith antibody. She fulfilled 4/11 of the ACR criteria and met 5 of the SLICC (Systemic Lupus International Collaborating Clinics) criteria for lupus (nonscaring alopecia, thrombocytopenia, positive ANA, and positive anti-Smith and positive anti-phospholipid antibodies). This case highlights the importance of early recognition of underlying connective tissue diseases and timely management of these diseases in young patients with no previous manifestations of diseases.
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spelling pubmed-45257592015-08-11 Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus Khan, Reshma M. Namas, Rajaie Parikh, Sachin Rubin, Bernard Case Rep Rheumatol Case Report We present a case of a 21-year-old African-American female with no significant medical history, who presented to the emergency department with a one-week history of blurry and double vision. Ophthalmology evaluation revealed bilateral retinal artery occlusion. Further workup with imaging of the brain was consistent with an ischemic stroke. Hereditary hypercoagulable workup was unremarkable and initial testing for antiphospholipid syndrome was positive. She underwent transesophageal echocardiogram (TEE), which showed severe mitral regurgitation and thickening of mitral valve leaflets consistent with Libman-Sacks endocarditis. Autoimmune workup was positive for IF-ANA, anti-RNP, and anti-Smith antibody. She fulfilled 4/11 of the ACR criteria and met 5 of the SLICC (Systemic Lupus International Collaborating Clinics) criteria for lupus (nonscaring alopecia, thrombocytopenia, positive ANA, and positive anti-Smith and positive anti-phospholipid antibodies). This case highlights the importance of early recognition of underlying connective tissue diseases and timely management of these diseases in young patients with no previous manifestations of diseases. Hindawi Publishing Corporation 2015 2015-07-22 /pmc/articles/PMC4525759/ /pubmed/26266073 http://dx.doi.org/10.1155/2015/373201 Text en Copyright © 2015 Reshma M. Khan et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Khan, Reshma M.
Namas, Rajaie
Parikh, Sachin
Rubin, Bernard
Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus
title Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus
title_full Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus
title_fullStr Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus
title_full_unstemmed Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus
title_short Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus
title_sort embolic stroke as the initial manifestation of systemic lupus erythematosus
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525759/
https://www.ncbi.nlm.nih.gov/pubmed/26266073
http://dx.doi.org/10.1155/2015/373201
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