Del Carpio-Orantes L, Rosas-Lozano AL, Sánchez-Díaz JS

Language: Spanish
References: 16
Page: 204-209
PDF size: 215.26 Kb.

ABSTRACT

Background: The antiphospholipid syndrome is an autoimmune, prothrombotic and systemic disorder characterized by arterial and/or venous thrombosis, recurrent fetal loss and persistently elevated antiphospholipid antibody titers.
Objective: To identify the various forms of manifestation of antiphospholipid syndrome and to highlight the administration of ribaroxaban as therapeutic option.
Material and Method: A retrospective, longitudinal and descriptive study in which the cases of arterial and venous thrombosis associated with thrombophilia type antiphospholipid syndrome presented during the period from 2016 to 2018 in a Hospital of Veracruz were analyzed.
Results: We found 7 patients with venous and arterial thrombotic symptoms that were studied antiphospholipid syndrome, the most affected gender was the female and the predominant age group was 21-30 years. The thrombotic event with the highest incidence was in the deep venous system of the pelvic extremities in 5 patients, in one case it was observed as a complication associated with pulmonary thromboembolism and in another case acute cerebral infarction. The antiphospholipid syndrome was primary in 6 cases and one associated with systemic lupus erythematosus.
Conclusion: We present a cohort of patients with an established diagnosis of antiphospholipid syndrome from a perspective of its broad spectrum of presentation, ranging from an asymptomatic patient to a catastrophic antiphospholipid syndrome.

REFERENCES

1. Ruiz-Irastorza G, Crowther M, Branch W, Khamashta MA. Antiphospholipid syndrome. Lancet 2010;376(9751):1498- 509.

2. Cohen D, Berger SP, Steup-Beekman GM, Bloemenkamp KW, Bajema IM. Diagnosis and management of the antiphospholipid syndrome. BMJ 2010 May 14;340:c2541, commentary can be found in BMJ;340:c2983.

3. Guía de práctica clínica, Tratamiento de síndrome de anticuerpos antifosfolípidos primario en el adulto. México, Secretaría de Salud, 2010.

4. Forastiero R, Martinuzzo M. Prothrombotic mechanisms based on the impairment of fibrinolysis in the antiphospholipid syndrome. Lupus 2008;17:872.

5. Urbanus RT, Derksen RH, de Groot PG. Platelets and the antiphospholipid syndrome. Lupus 2008;17:888.

6. Chen PP, Giles I. Antibodies to serine proteases in the antiphospholipid syndrome. Curr Rheumatol Rep 2010;12:45.

7. Canaud G, Bienaimé F, Tabarin F, et al. Inhibition of the mTORC pathway in the antiphospholipid syndrome. N Engl J Med 2014;371:303.

8. Mackworth-Young CG. Antiphospholipid syndrome: multiple mechanisms. Clin Exp Immunol 2004;136:393.

9. Ruiz-Irastorza G, Crowther M, Branch W, Khamashta MA. Antiphospholipid syndrome. Lancet 2010;376:1498.

10. Abreu MM, Danowski A, Wahl DG, et al. The relevance of “non-criteria” clinical manifestations of antiphospholipid syndrome: 14th International Congress on Antiphospholipid Antibodies Technical Task Force Report on Antiphospholipid Syndrome Clinical Features. Autoimmun Rev 2015;14:401.

11. Meroni PL, Chighizola CB, Rovelli F, Gerosa M. Antiphospholipid syndrome in 2014: more clinical manifestations, novel pathogenic players and emerging biomarkers. Arthritis Res Ther 2014;16:209.

12. Erkan D, Espinosa G, Cervera R. Catastrophic antiphospholipid syndrome: updated diagnostic algorithms. Autoimmun Rev 2010;10:74.

13. Del Carpio L, Anaya C, Bonilla E. Síndrome antifosfolípidos catastrófico. Reporte de caso y revisión bibliográfica. Gac Méd Méx 2017;153:531-536.

14. Moncada B, Ruiz-Arguelles G, Johnson-Ponce O. Trombofilia en México. Gac Méd Méx 2017;153(4):496-502. doi: 10.24875/GMM.17002525.

15. Pengo V, Denas G. Rivaroxaban vs. warfarin in highrisk patients with antiphospholipid syndrome. Blood 2018;132:1365-71. 10.1182/blood-2018-04-848333

16. Garcia D, Erkan D. Diagnosis and management of the antiphospholipid syndrome. N Engl J Med 2018;378(21):2010-21. https://doi.org/10.1056/NEJMra1705454