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Plasma Exchange in the Management of Catastrophic Antiphospholipid Syndrome
Objective. Report of a case of catastrophic antiphospholipid syndrome (CAPS) with multiple organ involvement leading to a life-threatening condition despite early combination corticosteroid and heparin therapy. Initiation of plasma exchange led to rapid improvement of the patient's general cond...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5090084/ https://www.ncbi.nlm.nih.gov/pubmed/27833765 http://dx.doi.org/10.1155/2016/5375080 |
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author | Titeca-Beauport, Dimitri Salle, Valery Kontar, Loay Maizel, Julien Choukroun, Gabriel |
author_facet | Titeca-Beauport, Dimitri Salle, Valery Kontar, Loay Maizel, Julien Choukroun, Gabriel |
author_sort | Titeca-Beauport, Dimitri |
collection | PubMed |
description | Objective. Report of a case of catastrophic antiphospholipid syndrome (CAPS) with multiple organ involvement leading to a life-threatening condition despite early combination corticosteroid and heparin therapy. Initiation of plasma exchange led to rapid improvement of the patient's general condition. Design. Case report. Setting. University teaching hospital medical intensive care unit. Patient. Single case: 52-year-old man hospitalized for catastrophic antiphospholipid syndrome (CAPS) with cardiac, renal, and cutaneous involvement. Despite early methylprednisolone and heparin therapy, the patient's condition progressively deteriorated, resulting in acute renal failure, right adrenal hemorrhage, and pulmonary involvement, leading to acute respiratory distress on day 6, requiring high-flow nasal cannula oxygen therapy with FiO(2) of 1.0. Interventions. Plasma exchange was started on day 6. Endpoints and Main Results. A marked improvement of the patient's general condition was observed after initiation of plasma exchange, with successful weaning of oxygen therapy and normalization of platelet count, troponin, and serum creatinine within four days. Conclusions. This case illustrates the efficacy of plasma exchange in CAPS and the difficulty for physicians to determine the optimal timing of plasma exchange. |
format | Online Article Text |
id | pubmed-5090084 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-50900842016-11-10 Plasma Exchange in the Management of Catastrophic Antiphospholipid Syndrome Titeca-Beauport, Dimitri Salle, Valery Kontar, Loay Maizel, Julien Choukroun, Gabriel Case Rep Crit Care Case Report Objective. Report of a case of catastrophic antiphospholipid syndrome (CAPS) with multiple organ involvement leading to a life-threatening condition despite early combination corticosteroid and heparin therapy. Initiation of plasma exchange led to rapid improvement of the patient's general condition. Design. Case report. Setting. University teaching hospital medical intensive care unit. Patient. Single case: 52-year-old man hospitalized for catastrophic antiphospholipid syndrome (CAPS) with cardiac, renal, and cutaneous involvement. Despite early methylprednisolone and heparin therapy, the patient's condition progressively deteriorated, resulting in acute renal failure, right adrenal hemorrhage, and pulmonary involvement, leading to acute respiratory distress on day 6, requiring high-flow nasal cannula oxygen therapy with FiO(2) of 1.0. Interventions. Plasma exchange was started on day 6. Endpoints and Main Results. A marked improvement of the patient's general condition was observed after initiation of plasma exchange, with successful weaning of oxygen therapy and normalization of platelet count, troponin, and serum creatinine within four days. Conclusions. This case illustrates the efficacy of plasma exchange in CAPS and the difficulty for physicians to determine the optimal timing of plasma exchange. Hindawi Publishing Corporation 2016 2016-10-19 /pmc/articles/PMC5090084/ /pubmed/27833765 http://dx.doi.org/10.1155/2016/5375080 Text en Copyright © 2016 Dimitri Titeca-Beauport et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Titeca-Beauport, Dimitri Salle, Valery Kontar, Loay Maizel, Julien Choukroun, Gabriel Plasma Exchange in the Management of Catastrophic Antiphospholipid Syndrome |
title | Plasma Exchange in the Management of Catastrophic Antiphospholipid Syndrome |
title_full | Plasma Exchange in the Management of Catastrophic Antiphospholipid Syndrome |
title_fullStr | Plasma Exchange in the Management of Catastrophic Antiphospholipid Syndrome |
title_full_unstemmed | Plasma Exchange in the Management of Catastrophic Antiphospholipid Syndrome |
title_short | Plasma Exchange in the Management of Catastrophic Antiphospholipid Syndrome |
title_sort | plasma exchange in the management of catastrophic antiphospholipid syndrome |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5090084/ https://www.ncbi.nlm.nih.gov/pubmed/27833765 http://dx.doi.org/10.1155/2016/5375080 |
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