engleski

Multiple intracerebral hemorrhages in a patient with systemic sclerosis sine scleroderma

We present a 62-year-old male patient who was admitted to a hospital with pulsatile headache and cognitive decline. His history revealed pulmonary fibrosis and cardiomyopathy for past 7 years. No significant skin thickening on physical examination was found, but he referred an episodic digital ischemia provoked by cold indicative to Raynaud’s phenomenon (RP). Serologic studies showed positive anti-nuclear antibodies (ANA) and autoantibodies directed against topoisomerase (anti-DNA topo I). An MRI at clinic revealed multiple hyperintense lesions of supra- and infra- tentorial localization (Fig. 1), which were interpreted as suggestive of subacute intracerebral hemorrhages. An MRI angiogram ruled out any aneurysms, vascular malformations or venous occlusion. Based on serologic findings, a high index of suspicion for systemic sclerosis was increased. A biopsy of the skin confirmed sclerosing dermatosis (Fig. 1b–d). Additionally, fibrotic destruction of internal organs, were found, including...

Sclerosis sine scleroderma ; Anti-topoisomerase I ; cerebral hemorrhage

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