Ozaras Resat, Mete Birgul, Hakko Elif, Mert Ali, Tabak Fehmi, Bilir Muammer, Akman Canan, Ozturk Recep
Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical Faculty, Turkey.
Intern Med. 2003 Apr;42(4):358-61. doi: 10.2169/internalmedicine.42.358.
Antiphospholipid syndrome (APS) is defined as the occurrence of thrombosis, recurrent miscarriage, or both in association with laboratory evidence of persistent antiphospholipid antibodies. Owing to protean manifestations and laboratory studies, the diagnosis may be difficult. Because the other signs and symptoms of thrombosis are predominant, prolonged fever is not usually the main clinical finding. We describe a patient who presented with fever of unknown origin (FUO) and was found to have thromboses of the splenic vein, the superior mesenteric vein, and the portal vein due to the primary antiphospholipid syndrome. We also reviewed the medical literature (Medline 1966-2001), including the main FUO series of the previous 40 years, and laparotomy series for FUO. We conclude that although very rare, primary APS and thrombosis may present with FUO. APS should be considered in the differential diagnosis of prolonged fever associated with thrombosis.
抗磷脂综合征（APS）的定义为出现血栓形成、复发性流产或两者兼有，同时伴有持续抗磷脂抗体的实验室证据。由于其表现形式多样且需进行实验室检查，诊断可能会很困难。因为血栓形成的其他体征和症状较为突出，所以长期发热通常并非主要的临床发现。我们描述了一名以不明原因发热（FUO）就诊的患者，该患者因原发性抗磷脂综合征出现脾静脉、肠系膜上静脉和门静脉血栓形成。我们还查阅了医学文献（1966 - 2001年的Medline），包括过去40年主要的不明原因发热系列研究以及不明原因发热的剖腹探查系列研究。我们得出结论，尽管非常罕见，但原发性抗磷脂综合征和血栓形成可能表现为不明原因发热。在鉴别诊断伴有血栓形成的长期发热时应考虑抗磷脂综合征。
