title: Unusual co-existence of dural sinus thrombosis and aneurysmal subarachnoid hemorrhage in a patient with lupus.
abstract: Subarachnoid hemorrhage and dural sinus thrombosis are important manifestations of neuropsychiatric lupus erythematosus. We report the case of a woman with relapsed lupus nephritis, in partial remission, who presented with the unusual combination of dural sinus thrombosis (due to protein S functional deficiency) and aneurysmal subarachnoid hemorrhage. She had a fatal outcome, as has often been reported with subarachnoid hemorrhage in the context of active lupus. To our knowledge, this is the first report of such an unusual association in lupus, and highlights unique challenges in the management of intracranial hemorrhage in the context of dural sinus thrombosis.
authors: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India durgapmisra@gmail.com.
authors: D P
authors: DP
authors: Misra
authors: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors: A C
authors: AC
authors: Chowdhury
authors: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors: J R
authors: JR
authors: Parida
authors: Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors: S K
authors: SK
authors: Jain
authors: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors: V
authors: V
authors: Agarwal
mesh_terms: D000328:Adult; D001706:Biopsy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008181:Lupus Nephritis / Q000150:complications* / Q000473:pathology; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications* / Q000473:pathology; D012008:Recurrence; D012851:Sinus Thrombosis, Intracranial / Q000150:complications*; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D014057:Tomography, X-Ray Computed
keywords: Neuropsychiatric lupus; anticoagulation; nephritis; systemic lupus erythematosus; thrombosis