Tiperneni Raghu, Tayyeb Muhammad, Fichadiya Harshil, Al-Alwan Ahmad, Khalid Farhan, Rajamohan Adhithya
Internal Medicine, Monmouth Medical Center, Long Branch, USA.
Cureus. 2022 Jun 4;14(6):e25659. doi: 10.7759/cureus.25659. eCollection 2022 Jun.
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.
静脉血栓栓塞包括深静脉血栓形成（DVT）和肺栓塞，是仅次于冠心病和中风的最常见心血管疾病。抗磷脂综合征（APS）是一种自身免疫性疾病，其特征是静脉或动脉血栓形成，并伴有抗磷脂抗体的实验室证据。需要长期抗凝治疗以预防复发性DVT、栓塞和血栓形成相关并发症。治疗选择包括维生素K拮抗剂、皮下注射低分子量肝素、普通肝素或直接口服抗凝剂。华法林（一种维生素K拮抗剂）仍然是有DVT既往史的APS患者的主要治疗药物，并且与国际标准化比值升高有关，该比值通常用作治疗适宜性和华法林剂量的标志物。在此，我们描述了一例独特病例，一名65岁女性，患有APS且正在服用华法林（既往有下肢DVT），出现左乳房出血/血肿和左上肢血栓。
