Bangolo Ayrton, Sagireddy Sowmya, Mahamadeen Sarah, Hasta Felicia, Reddy Sadhu A, Naz Afshan, Ranganatha Ravishankar, Ricketts Cleveland, Muppalla Padmavathi, Veliginti Swathi, Arana Georgemar, Sathyarajan Dily T, Singh Sachin, Shetty Tanvi, Bhardwaj Kshitij, Hashemy Sayed, Duran Roberto L, Kim Sung H, Hipolito Candice M, Yoon Kibo, Patel Vrusha, Alshimari Aseel, Inban Pugazhendi, Yasmeen Saaniya, Weissman Simcha
Department of Internal Medicine, Hackensack University Medical Center/Palisades Medical Center, North Bergen, NJ, USA.
J Community Hosp Intern Med Perspect. 2023 May 8;13(3):79-82. doi: 10.55729/2000-9666.1175. eCollection 2023.
A small subset of patients with antiphospholipid syndrome (APS) may develop widespread thrombotic disease with organ damage, referred to as catastrophic APS (CAPS) that is associated with a high mortality. Medical therapy typically involves a combination of anticoagulation, systemic glucocorticoids, plasmapheresis, and intravenous immune globulin (IVIG). There is currently no consensus for the management of refractory cases of CAPS. However, monoclonal antibodies such as rituximab and eculizumab have shown some benefits. Herein, we present a 29-year-old female with previous pulmonary embolism who presented with necrotic left toes and was eventually diagnosed with refractory CAPS, successfully treated with Plasmapheresis and Rituximab. With this case report, we hope to encourage the usage of Rituximab in the management of CAPS.
一小部分抗磷脂综合征（APS）患者可能会出现伴有器官损害的广泛血栓形成疾病，即灾难性抗磷脂综合征（CAPS），其死亡率很高。药物治疗通常包括抗凝、全身性糖皮质激素、血浆置换和静脉注射免疫球蛋白（IVIG）。目前对于CAPS难治性病例的管理尚无共识。然而，诸如利妥昔单抗和依库珠单抗等单克隆抗体已显示出一些益处。在此，我们报告一名29岁既往有肺栓塞的女性，她出现左脚趾坏死，最终被诊断为难治性CAPS，经血浆置换和利妥昔单抗成功治疗。通过本病例报告，我们希望鼓励在CAPS管理中使用利妥昔单抗。
