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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2018, Number 4

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An Med Asoc Med Hosp ABC 2018; 63 (4)

Thrombotic storm: catastrophic antiphospholipid syndrome

Palacios MP, Monter VJE, Martínez REA, Camarena AG

Language: Spanish
References: 44
Page: 299-305
PDF size: 206.71 Kb.


ABSTRACT

Catastrophic antiphospholipid syndrome belongs to a group of diseases whose characteristic is focused on a state of extreme hypercoagulability. It occurs in approximately 1% of patients with antiphospholipid syndrome and its impact on mortality is up to 50% of cases. We present the case of a 41-year-old patient with a history of hypertension and antiphospholipid syndrome who was admitted to the Intensive Care Unit due to catastrophic antiphospholipid syndrome with central nervous system, pulmonary, renal (acute kidney injury) and cardiovascular (congestive heart failure, severe mitral regurgitation and myocarditis). During his hospitalization he was offered treatment to suppress the thrombotic process with anticoagulants, corticosteroids, plasmapheresis, intravenous immunoglobulin and hydroxychloroquine; as well as supportive therapy with mechanical ventilation, inotropic support, continuous renal replacement therapy in continuous veno-venous hemodiafiltration. Given the severity of mitral regurgitation, mitraclip was placed and thus the degree of insufficiency was reduced, however, this is failed due to detachment of the clip, so a surgical valvular change was made. Subsequently, it presents clinical improvement at the pulmonary, hemodynamic and renal levels. He presented epileptic status with torpid evolution and death.


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