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Plasmodium Vivax Malaria with Common and Carotid Artery Thrombosis and Antiphospolipid Antibody Syndrome-An Unusual Presentation
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In recent years, the association between infection&anti-phospholipid antibody syndrome have been reported in several epidemiologic&experimental studies that support the idea of infectious induction of Anti-phospholipid Syndrome.(1)(2) Herein we report 72 yr premorbidly healthy male presented with P.vivax malaria with multi-organ dysfunction syndrome with ARDS. On 6th day of admission, he developed left side hemiplegia. MRI+MRA (BRAIN) showed Right ACA territory infarct&thrombosed right common&internal carotid artery thrombosis. Autoimmune work-up showed ACLA IgM; APLA IgM; β2-glycoprotein-1 IgM were highly significant titre [58.9 MPL/ml,58.3 U/ml,113.9 RU/ml respectively]. Infections like malaria triggering Anti-phospholipid antibody Syndrome has been described in paediatric age groups. So Plasmodium vivax malaria with hepatic involvement with ARDS with common&internal carotid thrombosis due to secondary APLA Syndrome in geriatric age group is very unusual presentation. We managed this patient with anti-malarials, supportive therapy, anti-coagulation with heparin followed by warfarin overlap with PT/INR monitoring.
Keywords
P.Vivax Malaria, Anti-Phospholipid Antibody Syndrome, Carotid Artery Thrombosis.
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