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Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome
In this report, we describe the case of a woman with suspected COVID-19 immunization-induced probable catastrophic antiphospholipid syndrome. The patient is a 35-year-old female with a past medical history significant for antiphospholipid syndrome, not on anticoagulation, who presented with a 5-day...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410733/ https://www.ncbi.nlm.nih.gov/pubmed/36042994 http://dx.doi.org/10.7759/cureus.27313 |
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author | Seeley, Elizabeth A Zimmer, Markie Berghea, Ramona |
author_facet | Seeley, Elizabeth A Zimmer, Markie Berghea, Ramona |
author_sort | Seeley, Elizabeth A |
collection | PubMed |
description | In this report, we describe the case of a woman with suspected COVID-19 immunization-induced probable catastrophic antiphospholipid syndrome. The patient is a 35-year-old female with a past medical history significant for antiphospholipid syndrome, not on anticoagulation, who presented with a 5-day history of abdominal pain and distention, nausea, vomiting, and shortness of breath. She had received her first dose of the Pfizer COVID-19 vaccine one day prior to the onset of symptoms. After extensive workup at an outside hospital, she was found to be in acute heart failure exacerbated by severe mitral and tricuspid regurgitation. She was transferred to our hospital for escalation of care. EKG showed evidence of prior inferior and septal myocardial infarction. Transesophageal echocardiogram (TEE) showed reduced ejection fraction, severe mitral and tricuspid regurgitation, and a left ventricular thrombus. Cardiac MRI showed subendocardial late gadolinium enhancement indicative of ischemia. However, CTA of the coronary vessels showed no signs of obstruction. Therefore, her acute heart failure was thought to be due to small vessel thrombosis secondary to antiphospholipid syndrome. During admission, she had several absence seizure-like episodes. CT head showed several hypodensities of the deep white matter and brain MRI demonstrated multiple hyperintense T2 FLAIR signal foci with restriction diffusion and enhancement involving the cerebral hemisphere, consistent with subacute strokes attributed to being secondary to antiphospholipid syndrome or embolic from the left ventricular thrombus. She was treated with heparin for suspected catastrophic antiphospholipid syndrome and high-dose corticosteroid therapy for concomitant Systemic Lupus Erythematosus (SLE). She was discharged in a stable condition. |
format | Online Article Text |
id | pubmed-9410733 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-94107332022-08-29 Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome Seeley, Elizabeth A Zimmer, Markie Berghea, Ramona Cureus Internal Medicine In this report, we describe the case of a woman with suspected COVID-19 immunization-induced probable catastrophic antiphospholipid syndrome. The patient is a 35-year-old female with a past medical history significant for antiphospholipid syndrome, not on anticoagulation, who presented with a 5-day history of abdominal pain and distention, nausea, vomiting, and shortness of breath. She had received her first dose of the Pfizer COVID-19 vaccine one day prior to the onset of symptoms. After extensive workup at an outside hospital, she was found to be in acute heart failure exacerbated by severe mitral and tricuspid regurgitation. She was transferred to our hospital for escalation of care. EKG showed evidence of prior inferior and septal myocardial infarction. Transesophageal echocardiogram (TEE) showed reduced ejection fraction, severe mitral and tricuspid regurgitation, and a left ventricular thrombus. Cardiac MRI showed subendocardial late gadolinium enhancement indicative of ischemia. However, CTA of the coronary vessels showed no signs of obstruction. Therefore, her acute heart failure was thought to be due to small vessel thrombosis secondary to antiphospholipid syndrome. During admission, she had several absence seizure-like episodes. CT head showed several hypodensities of the deep white matter and brain MRI demonstrated multiple hyperintense T2 FLAIR signal foci with restriction diffusion and enhancement involving the cerebral hemisphere, consistent with subacute strokes attributed to being secondary to antiphospholipid syndrome or embolic from the left ventricular thrombus. She was treated with heparin for suspected catastrophic antiphospholipid syndrome and high-dose corticosteroid therapy for concomitant Systemic Lupus Erythematosus (SLE). She was discharged in a stable condition. Cureus 2022-07-26 /pmc/articles/PMC9410733/ /pubmed/36042994 http://dx.doi.org/10.7759/cureus.27313 Text en Copyright © 2022, Seeley et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Seeley, Elizabeth A Zimmer, Markie Berghea, Ramona Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome |
title | Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome |
title_full | Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome |
title_fullStr | Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome |
title_full_unstemmed | Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome |
title_short | Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome |
title_sort | suspected covid-19 immunization-induced probable catastrophic antiphospholipid syndrome |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410733/ https://www.ncbi.nlm.nih.gov/pubmed/36042994 http://dx.doi.org/10.7759/cureus.27313 |
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