phenprocoumon and Lupus-Erythematosus--Systemic

Movement disorders have only rarely been reported in association with antiphospholipid syndrome (APS). In such cases, chorea is the most common disorder observed, with occasional reports of hemidystonia, Parkinsonism, and hemiballism. We report here on 3 cases of APS (3 women ages 16, 46, and 56 years) who presented with movement disorders, including tics, tremor, myoclonus, and a corticobasal syndrome, never or rarely reported in association with this disease. Mild executive dysfunction was observed in all 3 patients. We also report the successful treatment of two of these patients with mild oral anticoagulation (INR 2-3). Movement disorders in APS seem more clinically heterogeneous than previously thought. Oral anticoagulation should be considered in the treatment of movement disorders associated with APS.

Topics: Adolescent; Antiphospholipid Syndrome; Brain; Cerebral Infarction; Diagnosis, Differential; Dyskinesias; Electroencephalography; Electromyography; Female; Follow-Up Studies; Frontal Lobe; Humans; Lupus Erythematosus, Systemic; Magnetic Resonance Imaging; Middle Aged; Movement Disorders; Myoclonus; Neurologic Examination; Neuropsychological Tests; Occipital Lobe; Phenindione; Phenprocoumon; Sneddon Syndrome; Spinocerebellar Degenerations; Tics; Tourette Syndrome; Tremor; Warfarin

Thrombolytic therapy is a well-defined treatment option for arterial and venous thrombosis in adults. In contrast, uniform recommendations regarding the indication, route of administration, and dosing of thrombolytic therapy in children are not available. The authors report the successful resolution of bilateral pulmonary embolism and popliteal artery thrombosis in an 11-year-old girl and 13-year-old girl, respectively, by catheter-directed thrombolysis with low-dose recombinant tissue plasminogen activator. Catheter-directed low-dose thrombolysis is an efficient treatment option for severe venous and arterial thrombosis in children.

Topics: Adolescent; Age Factors; Anticoagulants; Arthroscopy; Child; Dose-Response Relationship, Drug; Drug Therapy, Combination; Estrogens; Female; Fibrinolytic Agents; Hematoma; Heparin; Humans; Injections, Intra-Arterial; Knee Injuries; Lupus Erythematosus, Systemic; Phenprocoumon; Popliteal Artery; Postoperative Complications; Progesterone; Pulmonary Artery; Pulmonary Embolism; Recombinant Proteins; Sex Chromosome Disorders; Thrombolytic Therapy; Thrombophilia; Thrombosis; Tissue Plasminogen Activator; Trisomy

Topics: Adult; Anticoagulants; Azathioprine; Drug Antagonism; Female; Humans; Immunosuppressive Agents; Lupus Erythematosus, Systemic; Middle Aged; Phenprocoumon; Prothrombin Time; Thrombosis