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免疫性血小板减少性紫癜中的灾难性抗磷脂综合征——绝非偶然并存!

Catastrophic Antiphospholipid Syndrome in Immune Thrombocytopenic Purpura - Beyond Tenuous Concomitance!

作者信息

Joshi Arun, Sood Vivek, Mendonca Satish, Dogra Manu, Batta Gaurav, Tiwari Rohit, Yanamandra Uday

机构信息

Department of Nephrology, Army Hospital (Research and Referral), New Delhi, India.

Department of Nephro-Pathology, Army Hospital (Research and Referral), New Delhi, India.

出版信息

Indian J Nephrol. 2020 Nov-Dec;30(6):424-426. doi: 10.4103/ijn.IJN_188_19. Epub 2020 Nov 19.

Abstract

Significance of antiphospholipid antibodies in immune thrombocytopenic purpura is debatable and pose a diagnostic and therapeutic dilemma. Catastrophic antiphospholipid syndrome is a rare life-threatening entity, occurring in patients with antiphospholipid syndrome, usually after a triggering event. We describe an adult lady of chronic immune thrombocytopenic purpura (in remission) with antiphospholipid antibodies, who presented with rapidly progressive renal failure and had primary antiphospholipid syndrome nephropathy. The index manuscript titled exemplifies the fact that although the presence of APLA in ITP is known, however, management in the absence of clinical event remains debatable and may carry a future risk of thrombotic event/s mandating close monitoring with a high index of suspicion.

摘要

抗磷脂抗体在免疫性血小板减少性紫癜中的意义存在争议,并且带来了诊断和治疗难题。灾难性抗磷脂综合征是一种罕见的危及生命的病症,发生于抗磷脂综合征患者中,通常在触发事件后出现。我们描述了一位患有抗磷脂抗体的慢性免疫性血小板减少性紫癜成年女性(处于缓解期),她出现了快速进展的肾衰竭,并患有原发性抗磷脂综合征肾病。标题所示的这篇索引文稿例证了这样一个事实,即虽然已知ITP中存在抗磷脂抗体,但在无临床事件的情况下其管理仍存在争议,并且可能带来未来血栓形成事件的风险,这就需要高度怀疑并进行密切监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3123/8023023/8803b97f2265/IJN-30-424-g001.jpg

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