RGUHS Nat. J. Pub. Heal. Sci Vol: 14 Issue: 4 eISSN: pISSN
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Cecil Ross*, Soumya Umesh**, Sanjukta***, Delon D Souza***
*Professor of Medicine and Head, Department of Haematology.** Assistant Professor of Medicine , ***Senior Resident in Medicine, St John's Medical College Bangalore
Corresponding author:
Dr Cecil Ross Professor of Medicine & Head, Department of Haematology St John's Medical College Bangalore
Abstract
Background: With the advent of newer imaging techniques like Computerised axial tomography (CT)scan, Magnetic Resonance Imaging (MRI), Magnetic Resonance arteriogram/ venogram (MRA / MRV) the clinical features and the assessment of cerebral venous thrombosis (CVT) are now well defined. Searches for underlying causes in patients presenting with Non puerperal CVTwere frustrating.
Objectives: In this prospective study, we assessed the incidence of Antiphospholipidantibodies(APLA) with both anticardiolipin antibodies (aCL) and Lupus anticoagulant (LA) and estimated the levels of Factor VIII coagulant protein. (F.VIII: C) in newly diagnosed subjects with non puerperal CVT.
Patients and Methods: This study included 51consecutive patients with CVT. The diagnosis was based on clinical features and either a CT scan with contrast, MRI, MRAor MRV.
Results: 38 cases out of 51 had either of these conditions. 9 cases had both LA positive and elevated FVIII.C levels elevated. 16 cases had only F.VIII.C Levels elevated and 13 cases were only LA positive. In 13 cases the testing was normal.
Conclusions: Our detection of Factor VIII greater than 150 IU/dl in 42% of patients provides with new evidence for the role of Factor VIII in the pathogenesis of CVT and represents a major risk factor. Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome. Our study has identified Lupus Anticoagulants in 41% and aCL in 4% and both LAand aCLin 10%.
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