Wang H C, Tu H C, Choi W M
Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2000 Jan;99(1):62-5.
The diagnosis of stroke in children and young adults can be difficult, and the causes of ischemic stroke often remains unexplained even after extensive evaluation. We present a 13-year-old girl who had two ischemic strokes within a period of 3 weeks. A carotid duplex study and magnetic resonance angiography confirmed total occlusion of the left internal carotid artery. Serum immunologic examination revealed a high titer of immunoglobulin G anticardiolipin antibody (45.7 GPL U/mL; normal range, 0-16.2 GPL U/mL). The patient received long-term anticoagulation treatment with warfarin 5 to 7.5 mg per day, and international normalized ratios were maintained between 2.4 and 4.0. She recovered completely 5 weeks after the first stroke and has been well during the 6 months of follow-up after the onset. This is the first reported case of childhood ischemic stroke secondary to primary antiphospholipid antibody syndrome in Taiwan. This case emphasizes the importance of evaluating antiphospholipid antibody levels in patients with unexplained ischemic strokes.
儿童和青年的中风诊断可能具有挑战性，即便经过全面评估，缺血性中风的病因往往仍不明确。我们报告一名13岁女孩，在3周内发生了两次缺血性中风。颈动脉双功超声检查和磁共振血管造影证实左颈内动脉完全闭塞。血清免疫学检查显示抗心磷脂抗体免疫球蛋白G滴度很高（45.7 GPL U/mL；正常范围为0 - 16.2 GPL U/mL）。患者接受了华法林长期抗凝治疗，每日剂量为5至7.5毫克，国际标准化比值维持在2.4至4.0之间。首次中风后5周她完全康复，发病后6个月的随访期间情况良好。这是台湾地区首例报告的继发于原发性抗磷脂抗体综合征的儿童缺血性中风病例。该病例强调了在不明原因缺血性中风患者中评估抗磷脂抗体水平的重要性。
