title: Cerebral venous thrombosis and acquired protein S deficiency: an uncommon cause of headache in systemic lupus erythematosus.
abstract: A 42-yr-old woman with hypertension and renal involvement due to systemic lupus erythematosus (SLE) developed unilateral headache followed by the sudden onset of confusion and a grand mal convulsion. Cerebral computed tomography was normal. A magnetic resonance imaging angiogram revealed cerebral venous thrombosis and a venous infarct. Nephrotic syndrome had resulted in an acquired protein S deficiency. A review of previous cases suggests that either renal disease with proteinuria or features of the antiphospholipid syndrome are prerequisites for the development of cerebral venous thrombosis in SLE. Low free-protein S levels may be an additional risk factor. Furthermore it is likely that this condition is underdiagnosed.
authors.affiliation: Department of Rheumatology, St George's Hospital, London.
authors.forename: C J
authors.initials: CJ
authors.lastname: Laversuch
authors.forename: M M
authors.initials: MM
authors.lastname: Brown
authors.forename: A
authors.initials: A
authors.lastname: Clifton
authors.forename: B E
authors.initials: BE
authors.lastname: Bourke
mesh_terms: D000328:Adult; D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis; D002550:Cerebral Veins; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008279:Magnetic Resonance Imaging; D009404:Nephrotic Syndrome / Q000150:complications; D018455:Protein S Deficiency / Q000150:complications*; D013924:Thrombophlebitis / Q000150:complications* / Q000175:diagnosis