del Carpio-Orantes Luis, Martínez-Anaya Chantall Citlally, Bonilla-Casas Elías
Unidad de Cuidados Intensivos; Hospital General de Zona No. 71, Delegación Veracruz Norte, Instituto Mexicano del Seguro Social, Veracruz, Ver., México.
Servicio de Cirugía General; Hospital General de Zona No. 71, Delegación Veracruz Norte, Instituto Mexicano del Seguro Social, Veracruz, Ver., México.
Gac Med Mex. 2017;153(4):531-536. doi: 10.24875/GMM.17003124.
The present document is the report of a case of a very rare clinical entity, which presents with acute multiorganic failure after a thrombotic storm related to antiphospholipid antibodies, the so-called catastrophic antiphospholipid syndrome, which began as a recurrent picture of mesenteric thrombosis, with a previous history of venous insufficiency and distal ulcers probably associated with an unidentified antiphospholipid; deserving management in intensive care and the consultation by the world expert, Dr. Ricard Cervera who confirmed the diagnosis and recommend treating as such entity, the patient's evolution was satisfactory so far. Final recommendations for diagnosis and current treatment options such as rituximab or eculizumab are made. The present case was added to the international registry that currently houses around 500 cases worldwide (International CAPS Registry).
本文件是一例极为罕见临床病例的报告,该病例在与抗磷脂抗体相关的血栓风暴后出现急性多器官功能衰竭,即所谓的灾难性抗磷脂综合征,起初表现为肠系膜血栓形成的反复发作,既往有静脉功能不全和远端溃疡病史,可能与一种不明抗磷脂抗体有关;该病例需要在重症监护下进行管理,并由世界专家里卡德·塞尔韦拉博士会诊,他确认了诊断并建议按此病症进行治疗,目前患者的病情进展令人满意。文中还给出了诊断的最终建议以及当前的治疗选择,如利妥昔单抗或依库珠单抗。本病例已被纳入国际登记册,目前全球约有500例病例(国际灾难性抗磷脂综合征登记册)。