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抗磷脂综合征的挑战:从诊断到自我护理的经验

The challenges of antiphospholipid syndrome: experience from diagnosis to self-care.

作者信息

Larmour Kathryn, Lewis Gareth, Benson Gary, Hanko Jennifer

机构信息

Regional Nephrology Unit, Belfast City Hospital, Belfast, UK.

Haemophilia and Thrombosis Centre, Belfast City Hospital, Belfast, UK.

出版信息

BMJ Case Rep. 2014 Jun 26;2014:bcr2014205072. doi: 10.1136/bcr-2014-205072.

Abstract

A young woman presented to our unit with pancreatitis and acute kidney injury (AKI) 4 weeks after initiation of an oral contraceptive. She subsequently developed seizures due to posterior reversible encephalopathy syndrome and required ongoing haemodialysis for oliguric AKI. Routine antiphospholipid antibody screen was normal, but arterial and venous thromboses were identified on renal biopsy. Further coagulation studies identified an antiphospholipid-dependent inhibitor confirming the suspected diagnosis of antiphospholipid syndrome. She remained seizure free with control of hypertension and was established on anticoagulation. She remained haemodialysis dependent performing this independently at a new self-care unit. She provides us with valuable insights into her experience encouraging us to reconsider our current methods of education and communication in our younger population of patients living with chronic disease.

摘要

一名年轻女性在开始口服避孕药4周后出现胰腺炎和急性肾损伤(AKI),就诊于我们科室。随后,她因后部可逆性脑病综合征出现癫痫发作,且因少尿型AKI需要持续进行血液透析。常规抗磷脂抗体筛查结果正常,但肾活检发现动脉和静脉血栓形成。进一步的凝血研究发现一种抗磷脂依赖性抑制剂,证实了抗磷脂综合征的疑似诊断。通过控制高血压,她不再发作癫痫,并开始接受抗凝治疗。她仍然依赖血液透析,在一个新的自我护理单元独立进行。她向我们分享了自己的宝贵经历,促使我们重新思考针对年轻慢性病患者群体的现有教育和沟通方法。

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The pathogenesis of the antiphospholipid syndrome.抗磷脂综合征的发病机制。
N Engl J Med. 2013 Mar 14;368(11):1033-44. doi: 10.1056/NEJMra1112830.
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The abdominal manifestations of the antiphospholipid syndrome.抗磷脂综合征的腹部表现。
Rheumatology (Oxford). 2007 Nov;46(11):1641-7. doi: 10.1093/rheumatology/kem158. Epub 2007 Jul 17.
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Antiphospholipid syndrome and the kidneys.抗磷脂综合征与肾脏
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