Jacobson Tatiana B, Kolade Victor O, Kapadia Avni S
Department of Internal Medicine, University of Tennessee College of Medicine, Chattanooga 37403, USA.
Tenn Med. 2010 Nov-Dec;103(10):35-6, 39.
A 27-year-old Hispanic female was admitted to hospital with fever, a sudden marked decrease in vision, and multi-organ failure shortly after preterm delivery by cesarean section for eclampsia. Her past history was significant for a spontaneous first trimester abortion and one live birth complicated by intrauterine growth retardation. She was found to have several focal brain infarcts, exudative retinal detachment, bilateral adrenal hemorrhage, renal insufficiency, hypertension and subsequently hypotension. Positive anticardiolipin antibodies, lupus anticoagulant, and anti-B2 glycoprotein-I, as well as deranged coagulation profile and PTT mixing studies aided in the diagnosis of catastrophic antiphospholipid antibody syndrome. Anticoagulation and high-dose intravenous steroids led to significant improvement in the patient's condition, including her vision.
一名27岁的西班牙裔女性因子痫行剖宫产早产术后不久，因发热、视力突然明显下降及多器官功能衰竭入院。她既往有孕早期自然流产史，一次活产并发宫内生长受限。检查发现她有多处局灶性脑梗死、渗出性视网膜脱离、双侧肾上腺出血、肾功能不全、高血压，随后出现低血压。抗心磷脂抗体、狼疮抗凝物及抗β2糖蛋白-I阳性，以及凝血指标紊乱和部分凝血活酶时间混合试验有助于灾难性抗磷脂抗体综合征的诊断。抗凝治疗及大剂量静脉用类固醇使患者病情显著改善，包括视力。
