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When Blood Is Being Difficult: Clotting and Bleeding in a Patient With Antiphospholipid Antibody Syndrome and Supratherapeutic International Normalized Ratio.

作者信息

Tiperneni Raghu, Tayyeb Muhammad, Fichadiya Harshil, Al-Alwan Ahmad, Khalid Farhan, Rajamohan Adhithya

机构信息

Internal Medicine, Monmouth Medical Center, Long Branch, USA.

出版信息

Cureus. 2022 Jun 4;14(6):e25659. doi: 10.7759/cureus.25659. eCollection 2022 Jun.


DOI:10.7759/cureus.25659
PMID:35677737
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9167035/
Abstract

Venous thromboembolism includes deep venous thrombosis (DVT) and pulmonary embolism and is the most common cardiovascular disease after coronary artery disease and stroke. Antiphospholipid syndrome (APS) is an autoimmune disorder that is characterized by venous or arterial thrombosis with laboratory evidence of antiphospholipid antibodies. Long-term anticoagulation therapy is required to prevent recurrent DVTs, embolisms, and thrombosis-related complications. Treatment options include vitamin K antagonists, subcutaneous low-molecular-weight heparin, unfractionated heparin, or direct oral anticoagulants. Warfarin (a vitamin K antagonist) remains the mainstay of treatment in APS patients with a prior history of DVT and is associated with elevation of the international normalized ratio which is often used as a marker for therapy appropriateness and warfarin dosing. Here, we describe a unique case of a 65-year-old female with APS on warfarin (given prior lower extremity DVT) presenting with bleeding/hematoma in the left breast and a clot in the left upper extremity.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3628/9167035/67b27df069ac/cureus-0014-00000025659-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3628/9167035/67b27df069ac/cureus-0014-00000025659-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3628/9167035/67b27df069ac/cureus-0014-00000025659-i01.jpg

相似文献

[1]
When Blood Is Being Difficult: Clotting and Bleeding in a Patient With Antiphospholipid Antibody Syndrome and Supratherapeutic International Normalized Ratio.

Cureus. 2022-6-4

[2]
Management of antiphospholipid antibody syndrome: a systematic review.

JAMA. 2006-3-1

[3]
A Difficult and Rare Case of Warfarin Refractory Antiphospholipid Syndrome Presenting With Catastrophic Antiphospholipid Syndrome Complicated by Gastrointestinal Bleeding.

Cureus. 2021-8-11

[4]
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Autoimmun Rev. 2021-1

[5]
Cardiovascular Disease in Antiphospholipid Syndrome.

Curr Vasc Pharmacol. 2020

[6]
Deep Venous Thrombosis and Pulmonary Embolism: Current Therapy.

Am Fam Physician. 2017-3-1

[7]
Current management of acute symptomatic deep vein thrombosis.

Am J Cardiovasc Drugs. 2001

[8]
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Biomedicines. 2020-11-17

[9]
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Medicine (Baltimore). 2016-11

[10]
Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome: Study Rationale and Design (ASTRO-APS).

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本文引用的文献

[1]
Antiplatelet and anticoagulant agents for primary prevention of thrombosis in individuals with antiphospholipid antibodies.

Cochrane Database Syst Rev. 2018-7-13

[2]
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J Thromb Haemost. 2015-10-5

[3]
Bleeding and thrombosis in a patient with primary antiphospholipid syndrome using norethisterone: a case report.

J Med Case Rep. 2015-4-22

[4]
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Hematology Am Soc Hematol Educ Program. 2013

[5]
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Autoimmun Rev. 2013-11-2

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Incidence of a first thromboembolic event in asymptomatic carriers of high-risk antiphospholipid antibody profile: a multicenter prospective study.

Blood. 2011-7-15

[7]
Use of fondaparinux in a patient with antiphospholipid antibody syndrome and heparin-associated thrombocytopenia.

J Thromb Haemost. 2006-7

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Circulation. 2003-6-17

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