Sneddon Syndrome: A Case Report Exploring the Current Challenges Faced with Diagnosis and Management.

Antiphospholipid syndrome Livedo racemosa Livedo reticularis Sneddon syndrome Stroke Vasculopathy

Journal

Case reports in neurology
ISSN: 1662-680X
Titre abrégé: Case Rep Neurol
Pays: Switzerland
ID NLM: 101517693

Informations de publication

Date de publication:
Historique:
received: 08 08 2019
accepted: 07 10 2019
entrez: 23 1 2020
pubmed: 23 1 2020
medline: 23 1 2020
Statut: epublish

Résumé

Sneddon syndrome (SS) is a rare medium-vessel vasculopathy which characteristically presents with livedo racemosa (LR) and complications such as strokes. This case report describes a female presenting acutely with a stroke and, initially, no evidence of LR. Her antiphospholipid antibodies were negative, and her neuroimaging revealed multiple territory strokes with extensive vasculopathy and fragile neo-formed vessel collateralisation. She had progressive memory loss and multiple transient ischaemic attacks on a background of established infarctions. SS should be considered in any idiopathic medium-vessel vasculopathy despite the absence of LR. Medical therapy can be challenging and the importance of antiphospholipid status in risk stratifying anticoagulation against antiplatelet therapy is discussed with a proposed rheumatology management strategy. The medical option of hydroxychloroquine should be considered in all patients in view of its anti-thrombotic properties and efficacy in diseases such as systemic lupus erythematosus and antiphospholipid syndrome with the suggestion that SS may be a

Identifiants

pubmed: 31966033
doi: 10.1159/000503955
pii: crn-0011-0357
pmc: PMC6959103
doi:

Types de publication

Case Reports

Langues

eng

Pagination

357-368

Informations de copyright

Copyright © 2019 by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial, or financial relationships that could be construed as a potential conflict of interest.

Références

Clin Neurol Neurosurg. 2015 Feb;129:34-6
pubmed: 25528372
J Stroke Cerebrovasc Dis. 2019 Aug;28(8):2098-2108
pubmed: 31160219
J Craniofac Surg. 2017 Sep;28(6):e522-e527
pubmed: 28060096
Medicine (Baltimore). 1999 Jul;78(4):209-19
pubmed: 10424203
BMJ Case Rep. 2009;2009:bcr2007131912
pubmed: 21687309
J Clin Neurosci. 2012 Feb;19(2):326-8
pubmed: 22118882
J Clin Neurosci. 2011 Jul;18(7):980-1
pubmed: 21565509
J Neurol Neurosurg Psychiatry. 2003 Apr;74(4):542-4
pubmed: 12640088
Arch Dermatol. 1993 Apr;129(4):437-47
pubmed: 8466214
Cephalalgia. 2006 Mar;26(3):225-32
pubmed: 16472327
N Engl J Med. 2014 Mar 6;370(10):911-20
pubmed: 24552284
Br J Dermatol. 1965 Apr;77:180-5
pubmed: 14278790
Arch Neurol. 1997 Jan;54(1):53-60
pubmed: 9006414
Medicine (Baltimore). 1989 Nov;68(6):366-74
pubmed: 2509856

Auteurs

Jonathan Cleaver (J)

Department of Neurology, Southmead Hospital, Bristol, United Kingdom.

Mario Teo (M)

Department of Neurosurgery, Southmead Hospital, Bristol, United Kingdom.

Shelley Renowden (S)

Department of Neuroradiology, Southmead Hospital, Bristol, United Kingdom.

Keith Miller (K)

Department of Pathology, Southmead Hospital, Bristol, United Kingdom.

Harsha Gunawardena (H)

Department of Rheumatology, Southmead Hospital, Bristol, United Kingdom.

Philip Clatworthy (P)

Department of Neurology, Southmead Hospital, Bristol, United Kingdom.

Classifications MeSH