Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Antiphospholipid Syndrome Refractory to Secondary Anticoagulating Prophylaxis after Deep Vein Thrombosis-Pulmonary Embolism

  • Gu, Kang Mo (Division of Allergy and Pulmonary Medicine, Department of Internal Medicine, Chung-Ang Universitiy Hospital, Chung-Ang University College of Medicine) ;
  • Shin, Jong Wook (Division of Allergy and Pulmonary Medicine, Department of Internal Medicine, Chung-Ang Universitiy Hospital, Chung-Ang University College of Medicine) ;
  • Park, In Won (Division of Allergy and Pulmonary Medicine, Department of Internal Medicine, Chung-Ang Universitiy Hospital, Chung-Ang University College of Medicine)
  • Received : 2014.10.03
  • Accepted : 2014.12.10
  • Published : 2014.12.31
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Abstract

Antiphospholipid syndrome (APS) is an acquired systemic autoimmune disorder characterized by a combination of clinical criteria, including vascular thrombosis or pregnancy morbidity and elevated antiphospholipid antibody titers. It is one of the causes of deep vein thrombosis and pulmonary embolism that can be critical due to the mortality risk. Overall recurrence of thromboembolism is very low with adequate anticoagulation prophylaxis. The most effective treatment to prevent recurrent thrombosis is long-term anticoagulation. We report on a 17-year-old male with APS, who manifested blue toe syndrome, deep vein thrombosis, pulmonary thromboembolism, and cerebral infarction despite adequate long-term anticoagulation therapy.

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References

  1. Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295-306. https://doi.org/10.1111/j.1538-7836.2006.01753.x
  2. Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT, et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum 2002;46: 1019-27. https://doi.org/10.1002/art.10187
  3. Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133(6 Suppl):454S-545S. https://doi.org/10.1378/chest.08-0658
  4. Lim W, Crowther MA, Eikelboom JW. Management of antiphospholipid antibody syndrome: a systematic review. JAMA 2006;295:1050-7. https://doi.org/10.1001/jama.295.9.1050
  5. Puente D, Pombo G, Forastiero R. Current management of antiphospholipid syndrome-related thrombosis. Expert Rev Cardiovasc Ther 2009;7:1551-8. https://doi.org/10.1586/erc.09.112
  6. Finazzi G, Marchioli R, Brancaccio V, Schinco P, Wisloff F, Musial J, et al. A randomized clinical trial of high-intensity warfarin vs. conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS). J Thromb Haemost 2005;3:848-53. https://doi.org/10.1111/j.1538-7836.2005.01340.x
  7. Crowther MA, Ginsberg JS, Julian J, Denburg J, Hirsh J, Douketis J, et al. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med 2003;349: 1133-8. https://doi.org/10.1056/NEJMoa035241
  8. Cervera R. 8th International Congress on Autoimmunity: new perspectives for refractory catastrophic antiphospholipid syndrome. Expert Rev Clin Immunol 2012;8:617-9. https://doi.org/10.1586/eci.12.48
  9. Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GR. The management of thrombosis in the antiphospholipid-antibody syndrome. N Engl J Med 1995;332:993-7. https://doi.org/10.1056/NEJM199504133321504