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Case Reports
Successfully intravenous thrombolytic therapy in systemic lupus erythematosus-related ischemic stroke: A case report.
- Guanglin Liu, Yong Wang, and Hongjian Guan.
- Stroke Center, Department of Neurology, Yanbian University Hospital, Yanji, Jilin, China.
- Medicine (Baltimore). 2024 Oct 25; 103 (43): e40203e40203.
RationaleStroke is a relatively frequent complication occurring in patients with systemic lupus erythematosus (SLE). The increasing number of patients with Ischemic Stroke secondary to SLE aroused the clinician's concern. SLE thrombosis markers, diagnostic high-resolution magnetic resonance image (HR-MRI), and therapeutic interventions for acute ischemic stroke were recently coming into focus perspectives from the field.Patient ConcernsA 42-year-old female with slurred speech and numbness in her left limb was admitted to our hospital.DiagnosesMagnetic resonance imaging (MRI) revealed right thalamic infarction with diffusion-weighted lesions. Prior to admission, the patient had a National Institute of Health Stroke Scale (NIHSS) score of 3.InterventionsIn light of the clinical manifestation, the American Heart Association/American Stroke Association (AHA/ASA) Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke (2019) should be referred to. The patient was treated with thrombolytic alteplase (rt-PA).OutcomesThe patient was hospitalized for 2 weeks and discharged after his symptoms improved.LessonsAfter thrombolysis, the NIHSS score of the patient decreased to zero. The computed tomography scan was reexamined 24 hours later, and no acute changes or hemorrhage were identified in the infarcted area. Subsequent imaging and serological analyses indicated that HR-MRI of the responsible vessel was negative, but the infarction in this patient was still regarded as being caused by vasculitis of the right posterior cerebral artery in the region supplying the thalamus. This is the first case of successful intravenous thrombolytic therapy with rt-PA in a patient with SLE secondary to stroke with an NIHSS score of 3. This provides further evidence for expanding the reference of indications with rt-PA intravenous thrombolysis.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
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