An Atypical Presentation of Antiphospholipid Syndrome

Abstract

Arterial thrombosis is a major cause of morbidity and mortality both in the United States and worldwide. Although the rate of strokes has fallen by a third each year, about 690,000 people experience a new or recurrent ischemic cerebral vascular accident (CVA). It is estimated that 1 in every 20 deaths in the United States of America is due to a CVA. There are various factors that increase the risk of developing arterial thrombosis. Classically, hypertension, elevated levels of low-density lipoprotein-cholesterol (LDL) and smoking are well-documented cardiovascular dependent risk factors implicated in thrombosis. Furthermore, diabetes, pregnancy, age, chemotherapeutics and infectious burden may also contribute to risk of arterial thrombosis. However, an often overlooked cause of thrombosis include autoimmune syndromes such as Systemic lupus erythematosus (SLE), rheumatoid arthritis, and antiphospholipid syndrome (APS). Specifically, antiphospholipid syndrome is a widely recognized autoimmune prothrombotic risk for both arterial and venous thrombosis. Female patients often present with a history of stillbirth as well as loss of multiple pregnancies which can increase the risk of ischemic stroke and MI. Nevertheless, men can have an atypical presentation of antiphospholipid syndrome. In this case report we are presenting a 31-year-old male with past medical history significant for white coat hypertension and obesity who was brought to the emergency department for evaluation of left arm weakness and sudden onset left facial droop