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Research


~ Medical Research ~


The Foundation's goals are to make all medical information about Sneddon's readily available both to patients and to doctors at this website.  (Look to our "What is it? FAQ's" page for patient-oriented medical information.)


At this page you'll ultimately find an organized presentation

of abstracts from every available medical article about

Sneddon's Syndrome. At this early stage we can offer

collections of abstracts on the following topics:


1. On Warfarin as the Most Effective Treatment for Sneddon's

2. The Sneddon's Patient's Optimal INR as 3 - 4

3. Is Sneddon's Autoimmune Disease?

4. Sneddon's and the Eyes

5. Sneddon's and Headache

6. Sneddon's and Tests for Antiphospholipid Antibodies


Below you will find the first (and certainly the most important) of these collections: "On Warfarin as the most Effective Treatment for Sneddon's".  While our site is still under construction please write to us for copies of others listed here, and do not hesitate to let us know what information you need!





On Warfarin as the Most Effective Treatment for Sneddon’s

 

 

1. 1. Sneddon's syndrome is a thrombotic vasculopathy: neuropathologic and neuroradiologic evidence.

 

Neurology. 1995 Mar;45(3 Pt 1):557-60.

Comment in: Neurology. 1996 Jun;46(6):1781-2.

 

Geschwind DH, FitzPatrick M, Mischel PS, Cummings JL.

Department of Neurology, UCLA School of Medicine 90024.

 

We report the first case of pathologic findings from brain biopsy in a patient with Sneddon's syndrome. The observations suggest that Sneddon's syndrome is not a vasculitis but is more comparable to the autoimmune vasculopathies such as the antiphospholipid antibody syndrome. Vascular thrombosis and emboli from cardiac sources are the likely causes of stroke in most cases. The success of warfarin in the treatment of antiphospholipid syndromes and the failure of immunosuppression and aspirin in the treatment of Sneddon's syndrome argue that warfarin anticoagulation may be the most appropriate intervention currently available.

 

PMID: 7898716

 

 

 

2. 2. Sneddon and antiphospholipid antibody syndromes causing bilateral thalamic infarction.

 

Pediatr Neurol. 1994 May;10(3):262-3.

 

Charles PD, Fenichel GM.

Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN 37212-3375.

 

A child suffered bilateral thalamic infarction secondary to Sneddon and antiphospholipid antibody syndromes. Her initial findings of hypersomnolence, mood disturbance, and amnesia are characteristic of bilateral thalamic infarction. Clinical and laboratory evaluation confirmed the diagnosis of both Sneddon and antiphospholipid antibody syndromes as the cause of her unusual stroke. The treatment of this patient, based on experience with adult patients, was long-term, high-intensity warfarin anticoagulation.

 

PMID: 8060434

 

 

 

3. 3. Perioperative management of a patient with Sneddon syndrome--a case report

 

Anaesthesiol Reanim. 2003;28(3):74-8.

 

Vagts DA, Arndt M, Nöldge-Schomburg GF.

 

Sneddon's syndrome is a rare combination of generalised livedo reticularis and cerebrovascular accidents. Its clinical presentation varies widely and its aetiology is still not known. 60 to 80% of patients are female. First symptoms of the syndrome are mostly repetitive cerebral strokes, but reduced perfusion of the skin, seen as blue or red-brown mottling, precedes the strokes. The vascular disease is generalised and often accompanied by arteriosclerosis, systemic arterial hypertension, valvular heart disease and the presence of antiphospholipid antibodies. The diagnostic procedures are complicated and have to exclude other autoimmunological diseases. Therapeutic options are anticoagulatory therapy with warfarin, ASS or heparin, reduction of endothelial proliferation with ACE-inhibitors, and improvement of microvascular perfusion with prostaglandine. The increased anaesthesiological risk with these patients is due to the acute risk of thromboembolism and ischaemic cerebral and cardiovascular insults. The anaesthetic management must provide stable perfusion pressures for cerebral and myocardial arteries and avoid increasing risk factors for thromboembolism such as increased blood viscosity or stasis due to improper positioning of the patient. The choice of anaesthetic drugs is dependent on good controllability for haemodynamic stability. The high risk of patients with Sneddon's syndrome justifies a more invasive haemodynamic monitoring and postoperative surveillance on an intensive care unit. This case report describes the anaesthesiological considerations for, and management of, a patient with Sneddon's syndrome who was admitted to hospital for vaginal hysterectomy.

 

PMID: 12872540

 

 

4. 4. Aspirin and antiphospholipid syndrome

[Article in French]

 

Rev Med Interne. 2000 Mar;21 Suppl 1:83s-88s.

 

Hachulla E, Piette AM, Hatron PY, Blétry O.

Service de médecine interne, hôpital Huriez, CHRU, Lille, France.

 

INTRODUCTION: Antiphospholipid syndrome is the most frequent cause of acquired thrombophilia. Aspirin may have some indications. CURRENT KONWLEDGE AND KEY POINTS: The usefulness of low doses of aspirin is now well demonstrated in the prevention of obstetric complications associated with antiphospholipid antibodies (especially pregnancy loss). When heparin is combined with low-dose aspirin, the recurrent rate of fetal loss is lower than 30%. In patients with arterial or venous thrombosis, there is a high rate of recurrence during the two first years except if high-dose warfarin was used (i.e., INR > or = 3). The association warfarin-aspirin in secondary prevention of thrombosis may be evaluated in prospective studies. It is not so clear in the literature and in our experience that warfarin is superior to aspirin in stroke recurrence prevention in patients with antiphospholipid antibodies, except in Sneddon's syndrome. There are no guidelines in primary thrombosis prevention in patients with antiphospholipid antibodies. In lupus patients, aspirin may not be sufficient after many years of follow-up in preventing a first episode of thrombosis. Prospective studies may be undertaken. Atherosclerotic patients with antiphospholipid antibodies are particularly exposed to the risk of thrombosis after revascularisation or angioplasty and stent implantation. Aspirin may have a place in those patients but these must be evaluated. FUTUR PROSPECTS AND PROJECTS: Except in prevention of obstetric complications, the usefulness of aspirin in patients with antiphospholipid antibodies must be evaluated in prospective studies.

 

PMID: 10763209

 

 

 5. Therapy of Sneddon syndrome.

 

Eur Neurol. 2002;48(3):126-32.

 

Flöel A, Imai T, Lohmann H, Bethke F, Sunderkötter C, Droste DW.

Department of Neurology, University of Münster, Münster, Germany. [email protected]

 

We report the case of a young woman with progressive cognitive decline and epilepsy. She showed ischemic cerebrovascular disease and proximal livedo racemosa. Antiphospholipid antibody (aPL) could not be detected and there were no microemboli on continuous transcranial Doppler ultrasonography monitoring. Histology of cerebral vessels showed intimal hyperplasia in small leptomeningeal venous vessels and micronecrosis of grey and white matter. We subsequently made the diagnosis of aPL-negative Sneddon Syndrome (SNS). Anticoagulation with warfarin could not be initiated because of a drug-resistant epilepsy with the risk of falls and subsequent bleeding; immunosuppression with steroids and azathioprine was ineffective, as was initial antiplatelet therapy with clopidogrel alone. However, when we intensified antiplatelet therapy by combining clopidogrel and ASS, a slowing of disease progression, as assessed by neuropsychological testing and magnetic resonance imaging, was noted on a follow-up after 6 months. Therapeutic options in SNS in both aPL-positive and aPL-negative patients with SNS are discussed. Copyright 2002 S. Karger AG, Basel

 

PMID: 12373028

 

 

6. 6. Sneddon's syndrome: a case report.

 

Cutis. 2001 Mar;67(3):211-4, 220. Review.

 

Lahti J, Yu T, Burnett JW, Lutz L, LaMonte MP, Gunawardane R.

 

We report a case of Sneddon's syndrome with the triad of livedo reticularis, hypertension, and neurologic symptoms. The procedures for diagnosis and the tests to delineate clotting abnormalities are examined.

 

PMID: 11270293

 

 

7. 7. Warfarin in Sneddon's syndrome.

 

Neurology. 1996 Jun;46(6):1781-2.

 

Dupont S, Fénelon G, Saiag P, Sirmai J.

 

No abstract available.

 

PMID: 8649599 



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