Bipolar disorder with thrombophilia: A case report of possible association

Abstract

A 26-year-old female who had an 8-year history of BD was hospitalized due to manic episode. Because of the ischemic lesions on the cranial resonance imaging and pyramidal tractus signs in the neurological examination, a comprehensive etiologic diagnostic work-up including consultation of the patient by the Rheumatology Department for the differential diagnosis of vasculitis was suggested by the consultant neurologist. Abnormal findings were heterozygotic fVL and MTHFR mutations and decreased Protein S level. Because of positive test results for thrombophilia factors, the Hematology Department consulted the patient and put her on acetylsalicylic acid 100 mg/day treatment. To our knowledge, this is a singular report of a case which suggests an association between thrombophilia, stroke, and BD. But answers to questions "Is BD caused by silent stroke?" and "Does silent stroke complicate the clinical picture of this patient?" in this case are not straightforward and confusing. It should be kept in mind that human being is a biopsychosocial entity. The patients should be evaluated globally not to stick on their signs only. This will result in the exact diagnosis of the patients providing them with accurate treatment that improves their quality of life. © Universitätsverlag Ulm GmbH 2009.