Otsubo Shigeru, Nitta Kosaku, Yumura Wako, Nihei Hiroshi, Mori Noriko
Department of Medicine, Kidney Center, Tokyo Women's Medical University.
Intern Med. 2002 Sep;41(9):725-9. doi: 10.2169/internalmedicine.41.725.
A case of antiphospholipid syndrome (APS) is reported. A 48-year-old man visited our hospital because of proteinuria. He had suffered from thrombosis and had high titers of antibodies to beta2-glycoprotein I (abeta2GPI) and anticardiolipin antibodies (aCLIgG) and thrombocytopenia. We started anticoagulation therapy using warfarin combined with prednisolone. Although platelet count was improved, the titers of anti-beta2GPI and aCLIgG still remained high. Therefore, double-filtration plasmapheresis (DFPP) was carried out to remove the antibodies. After the treatment with DFPP, cyclophosphamide was administered. These therapies resulted in lower titers of abeta2GPI and aCLIgG and no more thrombosis occurred. A combination therapy using warfarin, prednisolone, cyclophosphamide and DFPP might be effective for the treatment of patients with APS.
报告了一例抗磷脂综合征(APS)病例。一名48岁男性因蛋白尿前来我院就诊。他曾患血栓形成,抗β2糖蛋白I抗体(abeta2GPI)和抗心磷脂抗体(aCLIgG)滴度高,且有血小板减少症。我们开始使用华法林联合泼尼松龙进行抗凝治疗。尽管血小板计数有所改善,但抗β2GPI和aCLIgG滴度仍居高不下。因此,进行了双重过滤血浆置换(DFPP)以清除抗体。DFPP治疗后,给予环磷酰胺。这些治疗使abeta2GPI和aCLIgG滴度降低,且未再发生血栓形成。使用华法林、泼尼松龙、环磷酰胺和DFPP的联合治疗可能对APS患者的治疗有效。