Méndez FS, Cruz DMP, Vera LOL

Language: Spanish
References: 20
Page: 349-354
PDF size: 1238.28 Kb.

ABSTRACT

Catastrophic antiphospholipid syndrome is an entity with a high mortality that represents 0.8% of the cases of antiphospholipid antibodies syndrome. The preliminary criteria for classification are as follows: involvement of tree or more organs, systems and/or tissues, development of simultaneous manifestation in less than one week, histopathology corroboration of occlusion of small vessels in at least one organ or tissue, and laboratory confirmation of the presence of antiphospholipid antibodies (lupus anticoagulant and/or anticardiolipins antibodies). When the four criteria are fulfilled, then a definitive diagnosis is made.
Case: Men of 35 year old, whit history of recidivant ulcers of the malleoli of 6 years evolution. He was admitted with arterial insufficiency of right upper extremity, neurological impairment, loss of consciousness, respiratory insufficiency which needs mechanical ventilatory support. Later, arterial insufficiency of the left lower extremity is added to this picture. The patient presents loss of brain reflexes and brain death. He showed acute renal failure and acute myocardial infarction. Anticardioliopins IgG had value of: 20 IU/mL, lupic anticoagulant was higher than 12. Brain scan tomography showed left parietal infarction with extensión to left frontal, and occipital and right occipital regions. Skin biopsy from ulcer in left leg: Show fibrin trombo in capillary of the papillary dermis. The present case fulfills the criteria for syndrome (whit arterial thromboses of lower extremities and central nervous system, and with findings of renal and skin microangiopathy). The diagnosis of this study was made in delayed form and the evolution of the patient, until cerebral death, did impossible to administer the suitable treatment.

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