Recurrent Ischemic Stroke in a Patient with the Trousseau Syndrome Treated with Dabigatran
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- 作者：Kosuke Yoshida ; MD ; yoshidak@asahikawa.hosp.go.jp" class="auth_mail ; Takashi Kimura ; MD ; PhD ; Yoko Aburakawa ; MD ; PhD ; Yasuhiro Suzuki ; MD ; PhD ; Kenji Kuroda ; MD ; PhD ; Osamu Yahara ; MD ; PhD
- 关键词：Trousseau syndrome ; dabigatran ; cancer ; warfarin
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：July 2014
- 年：2014
- 卷：23
- 期：6
- 页码：1724-1726
- 全文大小：420 K
文摘
A 70-year-old man with multiple ischemic strokes was diagnosed with cardiac embolism and treated with dabigatran. Three months later, he suddenly developed vertigo and vomiting. Magnetic resonance imaging, showed recurrent lesions and blood tests revealed hypercoagulability, hypoproteinemia, and elevated cytokeratin 19 fragments that serve as a tumor marker of lung cancer. Chest computed tomography showed there were small nodules in bilateral lungs and swollen mediastinal lymph nodes. A conclusive diagnosis was impossible because the patient declined invasive procedures. We suspected primary lung cancer and diagnosed concomitant arterial thrombosis. We initially administered low-molecular-weight heparin, which we later changed to vitamin K antagonist. Although stroke did not recur thereafter, liver metastasis resulted in death 6 months later. The effectiveness of novel oral anticoagulants for preventing the Trousseau syndrome remains unclear. Further study is needed to prevent venous and arterial thromboses arising from the Trousseau syndrome.