Titeca-Beauport Dimitri, Salle Valery, Kontar Loay, Maizel Julien, Choukroun Gabriel
Medical Intensive Care Unit, Amiens University Medical Center, Amiens, France; Nephrology, Dialysis and Transplantation Department, Amiens University Medical Center, Amiens, France.
Department of Internal Medicine, Amiens University Medical Center, Amiens, France.
Case Rep Crit Care. 2016;2016:5375080. doi: 10.1155/2016/5375080. Epub 2016 Oct 19.
. Report of a case of catastrophic antiphospholipid syndrome (CAPS) with multiple organ involvement leading to a life-threatening condition despite early combination corticosteroid and heparin therapy. Initiation of plasma exchange led to rapid improvement of the patient's general condition. .
. University teaching hospital medical intensive care unit. . Single case: 52-year-old man hospitalized for catastrophic antiphospholipid syndrome (CAPS) with cardiac, renal, and cutaneous involvement. Despite early methylprednisolone and heparin therapy, the patient's condition progressively deteriorated, resulting in acute renal failure, right adrenal hemorrhage, and pulmonary involvement, leading to acute respiratory distress on day 6, requiring high-flow nasal cannula oxygen therapy with FiO of 1.0. . Plasma exchange was started on day 6. . A marked improvement of the patient's general condition was observed after initiation of plasma exchange, with successful weaning of oxygen therapy and normalization of platelet count, troponin, and serum creatinine within four days. . This case illustrates the efficacy of plasma exchange in CAPS and the difficulty for physicians to determine the optimal timing of plasma exchange.
报告一例灾难性抗磷脂综合征（CAPS）病例，该病例虽早期联合使用皮质类固醇和肝素治疗，但多器官受累导致危及生命的状况。开始血浆置换后，患者的一般状况迅速改善。
大学教学医院重症监护病房。单病例：一名52岁男性因灾难性抗磷脂综合征（CAPS）合并心脏、肾脏和皮肤受累入院。尽管早期使用甲泼尼龙和肝素治疗，患者病情仍逐渐恶化，导致急性肾衰竭、右肾上腺出血和肺部受累，在第6天出现急性呼吸窘迫，需要FiO为1.0的高流量鼻导管吸氧治疗。第6天开始进行血浆置换。开始血浆置换后，观察到患者的一般状况有明显改善，在四天内成功撤掉氧疗，血小板计数、肌钙蛋白和血清肌酐恢复正常。本病例说明了血浆置换在CAPS中的疗效以及医生确定血浆置换最佳时机的困难。
