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A Non-smoking Woman with Anti-phospholipid Antibodies Proved to Have Thromboangiitis Obliterans

A 48-year-old woman with severe pain and numbness of her right leg and foot was admitted to our hospital. She had never smoked and had little exposure to passive smoking. Initially, polyarteritis nodosa with anti-phospholipid antibodies was considered. Combination therapy with methylprednisolone pul...

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Detalles Bibliográficos
Autores principales: Shima, Natsuki, Akiyama, Yoichiro, Yamamoto, Shotaro, Kokuzawa, Ayako, Nagatani, Katsuya, Iwamoto, Masahiro, Matsubara, Daisuke, Kawai, Shigeo, Sato, Kojiro, Minota, Seiji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028403/
https://www.ncbi.nlm.nih.gov/pubmed/31588083
http://dx.doi.org/10.2169/internalmedicine.3372-19
Descripción
Sumario:A 48-year-old woman with severe pain and numbness of her right leg and foot was admitted to our hospital. She had never smoked and had little exposure to passive smoking. Initially, polyarteritis nodosa with anti-phospholipid antibodies was considered. Combination therapy with methylprednisolone pulse therapy, intravenous cyclophosphamide pulse therapy, vasodilators, antiplatelet agents, and anticoagulants was not effective. Vasculopathy was progressive, and she presented with gangrene of the toes. She required amputation of her right leg. The pathological findings of the amputated leg revealed thromboangiitis obliterans (TAO). TAO should be considered even in non-smoking women. Non-response to immunosuppressant and anticoagulant therapies may be a clue to the diagnosis of TAO.