Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, Israel.
Lupus. 2012 Jan;21(1):93-6. doi: 10.1177/0961203311412412. Epub 2011 Aug 15.
Superior vena cava syndrome (SVCS), is diagnosed following different degrees of central venous system obstruction, which traditionally was caused by infections, tumors or fibrosing mediastinitis. Recently the role of SVC thrombosis secondary to indwelling central venous devices or pacemaker leads as well as different hypercoagulable states have drawn much attention. In the current review we present a 58-year-old female patient who underwent recurrent pacemaker replacements due to recurrent infections. The patient was hospitalized with superior vena cava syndrome and multiple thrombi in the upper body circulation. Additionally the evaluation was conducted for thrombophilia, which revealed the presence of high titers of antiphospholipid antibodies, suggesting the concurrent diagnosis of the antiphospholipid syndrome (APS). This case reflects the changes in the etiology of SVCS, and the need for a comprehensive evaluation of patients, in the search for additional factors that may complicate a pacemaker insertion, such as the presence of antiphospholipid antibodies. We review the relevant literature and highlight the importance for an interdisciplinary approach in the treatment of SVCS nowadays.
上腔静脉综合征（SVCS）是在不同程度的中心静脉系统阻塞后诊断出来的，传统上这种阻塞是由感染、肿瘤或纤维性纵隔炎引起的。最近，由于留置中心静脉导管或起搏器导线引起的上腔静脉血栓形成以及不同的高凝状态引起了广泛关注。在本次回顾中，我们介绍了一位 58 岁的女性患者，她因反复感染而反复接受起搏器更换。该患者因上腔静脉综合征和上半身循环多处血栓形成住院。此外，还对血栓形成倾向进行了评估，结果显示存在高滴度抗磷脂抗体，提示同时诊断为抗磷脂抗体综合征（APS）。该病例反映了 SVCS 病因的变化，以及需要对患者进行全面评估，以寻找可能使起搏器插入复杂化的其他因素，如抗磷脂抗体的存在。我们回顾了相关文献，并强调了当今治疗 SVCS 时采用多学科方法的重要性。
