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Immunomodulation in the Treatment of Refractory Catastrophic Antiphospholipid Syndrome
Catastrophic antiphospholipid syndrome is a rare condition with high morbidity and mortality. We present a refractory case of catastrophic antiphospholipid syndrome with a view to highlight the importance of early identification and aggressive treatment of this condition. A 36-year-old female presen...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902127/ https://www.ncbi.nlm.nih.gov/pubmed/29805821 http://dx.doi.org/10.1155/2018/1041396 |
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author | Nath, Karthik McCann, Andrew |
author_facet | Nath, Karthik McCann, Andrew |
author_sort | Nath, Karthik |
collection | PubMed |
description | Catastrophic antiphospholipid syndrome is a rare condition with high morbidity and mortality. We present a refractory case of catastrophic antiphospholipid syndrome with a view to highlight the importance of early identification and aggressive treatment of this condition. A 36-year-old female presented with clinical manifestations of multiorgan vascular occlusion with a known history of primary antiphospholipid syndrome. The presentation was on a background of a recent change of her long-term anticoagulation from warfarin to therapeutic low-molecular-weight heparin. Given that multiorgan involvement with 3 organ systems occurred nearly simultaneously, a diagnosis of probable catastrophic antiphospholipid syndrome was made. Prompt therapeutic anticoagulation, antiplatelet, and glucocorticoid therapy was commenced. Despite this, the patient continued to demonstrate clinical features concerning for ongoing small vessel occlusion necessitating aggressive immunomodulatory therapy in the form of intravenous immunoglobulin, plasma exchange, and rituximab. |
format | Online Article Text |
id | pubmed-5902127 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-59021272018-05-27 Immunomodulation in the Treatment of Refractory Catastrophic Antiphospholipid Syndrome Nath, Karthik McCann, Andrew Case Rep Hematol Case Report Catastrophic antiphospholipid syndrome is a rare condition with high morbidity and mortality. We present a refractory case of catastrophic antiphospholipid syndrome with a view to highlight the importance of early identification and aggressive treatment of this condition. A 36-year-old female presented with clinical manifestations of multiorgan vascular occlusion with a known history of primary antiphospholipid syndrome. The presentation was on a background of a recent change of her long-term anticoagulation from warfarin to therapeutic low-molecular-weight heparin. Given that multiorgan involvement with 3 organ systems occurred nearly simultaneously, a diagnosis of probable catastrophic antiphospholipid syndrome was made. Prompt therapeutic anticoagulation, antiplatelet, and glucocorticoid therapy was commenced. Despite this, the patient continued to demonstrate clinical features concerning for ongoing small vessel occlusion necessitating aggressive immunomodulatory therapy in the form of intravenous immunoglobulin, plasma exchange, and rituximab. Hindawi 2018-04-01 /pmc/articles/PMC5902127/ /pubmed/29805821 http://dx.doi.org/10.1155/2018/1041396 Text en Copyright © 2018 Karthik Nath and Andrew McCann. http://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 Nath, Karthik McCann, Andrew Immunomodulation in the Treatment of Refractory Catastrophic Antiphospholipid Syndrome |
title | Immunomodulation in the Treatment of Refractory Catastrophic Antiphospholipid Syndrome |
title_full | Immunomodulation in the Treatment of Refractory Catastrophic Antiphospholipid Syndrome |
title_fullStr | Immunomodulation in the Treatment of Refractory Catastrophic Antiphospholipid Syndrome |
title_full_unstemmed | Immunomodulation in the Treatment of Refractory Catastrophic Antiphospholipid Syndrome |
title_short | Immunomodulation in the Treatment of Refractory Catastrophic Antiphospholipid Syndrome |
title_sort | immunomodulation in the treatment of refractory catastrophic antiphospholipid syndrome |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902127/ https://www.ncbi.nlm.nih.gov/pubmed/29805821 http://dx.doi.org/10.1155/2018/1041396 |
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