Abbas Aymen, Almarzooqi Noura, Harhara Thana
Department of Education, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
SAGE Open Med Case Rep. 2024 May 11;12:2050313X241252809. doi: 10.1177/2050313X241252809. eCollection 2024.
Catastrophic antiphospholipid antibody syndrome is a rare and severe subtype of antiphospholipid syndrome with multisystemic organ failure due to thromboembolic events, resulting in high mortality rates. The association between catastrophic antiphospholipid antibody syndrome and autoimmune thyroid diseases is rarely reported in the literature. We report a case of a 35-year-old previously healthy female with Graves' thyroid storm, positive lupus antibodies, and probable catastrophic antiphospholipid antibody syndrome. Her hospital course was complicated by extensive venous thromboembolism, superior vena cava syndrome, thromboembolic strokes, and Takotsubo cardiomyopathy. Eventually, this led to an unfortunate death secondary to profound shock after 8 days despite emergent treatment. Our case report discusses the link between autoimmune thyroid disorders and catastrophic antiphospholipid antibody syndrome. We emphasize the difficulty in diagnosing catastrophic antiphospholipid antibody syndrome in extremely ill patients and stress the significance of considering it as a possible cause in thyrotoxicosis patients with multiple organ failure and hypercoagulability. Early recognition and prompt management are crucial in improving outcomes in these patients.
灾难性抗磷脂抗体综合征是抗磷脂综合征的一种罕见且严重的亚型,因血栓栓塞事件导致多系统器官衰竭,死亡率很高。灾难性抗磷脂抗体综合征与自身免疫性甲状腺疾病之间的关联在文献中鲜有报道。我们报告一例35岁既往健康的女性,患有格雷夫斯甲状腺危象、狼疮抗体阳性以及可能的灾难性抗磷脂抗体综合征。她的住院过程因广泛静脉血栓栓塞、上腔静脉综合征、血栓栓塞性中风和应激性心肌病而复杂化。最终,尽管进行了紧急治疗,但在8天后仍因严重休克不幸死亡。我们的病例报告讨论了自身免疫性甲状腺疾病与灾难性抗磷脂抗体综合征之间的联系。我们强调在病情极其严重的患者中诊断灾难性抗磷脂抗体综合征的困难,并强调在患有多器官衰竭和高凝状态的甲状腺毒症患者中将其视为可能病因的重要性。早期识别和及时处理对于改善这些患者的预后至关重要。