Abstract
Background
Prothrombotic and pro-inflammatory states are known cerebral venous thrombosis risk
factors. To date, two cases of venous thrombotic events after immunoglobulin-E mediated
anaphylaxis have been reported. Herein, we describe the first case of cerebral venous
thrombosis in close temporal relation with an immunoglobulin-E mediated anaphylactic
event.
Case description
A 51-year-old female presented with headache, language, and mental disturbance lasting
for two days. Two days before the onset, she had undergone a provocative test with
deflazacort to study an allergy history; after the test she developed a severe anaphylactic
reaction. There were no other comorbidities, and in addition to contraceptive pill,
she did not take other medications.
On admission the patient was drowsy, with anomic aphasia, inattention and memory impairment.
Magnetic Resonance Imaging depicted a left caudate and lenticulo-capsulo-thalamic
venous infarct and thrombosis in the deep venous system. The patient was treated with
anticoagulation and showed progressive improvement. Neoplastic and pro-thrombotic
diseases were excluded.
Conclusion
The close temporal association between the anaphylactic reaction and cerebral venous
thrombosis suggests that anaphylactic reaction could have been a cerebral venous thrombosis
precipitating factor. Immunoglobulin-E have been suggested to have prothrombotic activity
by stimulating the release of platelet activation factor, thromboxane A2 and serotonin.
This case adds on to the available information on possible cerebral venous thrombosis
associated conditions.
Key Words
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References
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Article info
Publication history
Published online: November 09, 2022
Accepted:
November 2,
2022
Received in revised form:
November 1,
2022
Received:
October 16,
2022
Footnotes
All co-authors have read and approved the submission.
Work was performed at: Stroke Unit, Neurology, Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
Grant Support: This report received no specific grant from any funding agency in the public, commercial, or not-for-profit sector.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106873
Copyright
© 2022 Elsevier Inc. All rights reserved.
