Síndrome antifosfolípido

Parkinsonismo y deterioro cognitivo rápidamente progresivo en un paciente con lupus eritematoso sistémico y síndrome antifosfolípido triple positivo. Parkinsonism and rapidly progressive cognitive decline in a patient with systemic lupus erythematosus and triple-positive antiphospholipid syndrome.

Background: The association between parkinsonism and systemic lupus erythematosus is inadequately described, and to date, the underlying pathophysiological mechanisms are not fully established, ranging from vascular impairments to immunomediated phenomena. Literature analysis identified only 28 cases of parkinsonism in patients with systemic lupus erythematosus, underscoring the limited attention to these associations and their respective therapeutic approaches.

Case Report: We present a case of a patient with an atypical presentation of systemic lupus erythematosus and a diagnosis of triple-positive antiphospholipid syndrome. Despite the absence of lupus activity, the patient developed symptoms of parkinsonism and rapidly progressive cognitive decline. No other underlying causes or thrombotic events in brain imaging were found to explain the atypical clinical presentation. Simultaneous administration of immunosuppressive therapy and levodopa/carbidopa resulted in symptom improvement.

Conclusion: Insufficient research has been conducted on the correlation between systemic lupus erythematosus and parkinsonism, primarily due to its seemingly low incidence in the medical literature. Consequently, this case report offers additional insights into this association, potentially laying the groundwork for future structured and well-designed studies. The efficacy of levodopa and immunosuppressive therapy in treating these patients remains uncertain and necessitates further investigation.

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Palabras clave: autoinmunidad, lupus eritematoso sistémico, parkinsonismo, Síndrome antifosfolípido,

Keywords: Antiphospholipid syndrome, autoimmunitys, parkinsonism, systemic lupus erythematosus,

Presentación rara de síndrome antifosfolípido primario asociado a hiperhomocisteinemia como causa de enfermedad cerebrovascular isquémica recurrente en varón joven. Rare presentation of primary antiphospholipid syndrome associated with hyperhomocysteinemia as a cause of recurrent ischemic stroke in young male.

We present the case of a 38-year-old male patient with a history of recurrent ischemic cerebrovascular disease without determined etiology and venous thrombosis in lower limbs. Due to the aetiological diversity of cerebral infarction in a young adult, he underwent a series of clinical tests, which resulted in the diagnosis of a primary antiphospholipid syndrome associated with hyperhomocysteinemia.

Once the diagnosis was made, he was given therapy with anticoagulants and corticoid pulses; with posterior improvement. Antiphospholipid syndrome is part of the differential diagnosis in young women with cerebral infarction; most cases have been reported in its secondary form, but finding it in primary form and in a male patient is rare. Also, increased homocysteine values are related to the severity of the first cerebrovascular event, but not to recurrent events.