title: Cerebral Venous Thromboembolism in Antiphospholipid Syndrome Successfully Treated with the Combined Use of an Anti-Xa Inhibitor and Corticosteroid.
abstract: We herein report a case presenting with cerebral venous sinus thrombosis (CVST) associated with primary antiphospholipid syndrome (APS). The patient developed recurrent CVST followed by a hemorrhagic ischemic stroke despite the use of warfarin during the appropriate therapeutic window. Thus, we substituted warfarin to rivaroxaban with prednisolone and obtained a good clinical course. In addition to the effect of prednisolone of inhibiting elevated lupus anticoagulants and the recurrence of arterial thrombosis, rivaroxaban may prevent CVST and inhibit hypercoagulability induced by corticosteroids. The combination of an anti-Xa inhibitor and corticosteroid may be an alternative treatment for CVST and arterial thrombus with warfarin-resistant APS.
authors.affiliation: Department of Neurology, Showa University Fujigaoka Hospital, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sugie
authors.forename: Natsuko
authors.initials: N
authors.lastname: Iizuka
authors.forename: Yuki
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Hiroo
authors.initials: H
authors.lastname: Ichikawa
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069552:Rivaroxaban / Q000627:therapeutic use; D020521:Stroke / Q000150:complications; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy*; D054556:Venous Thromboembolism / Q000150:complications / Q000188:drug therapy*; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D014859:Warfarin; D000069552:Rivaroxaban