Mota Teresa, Queirós Pereira Rita, Leão Diana, Leite Ana Maria, Araújo Fernando
Immunohemotherapy Department, Unidade Local de Saúde de São João, Porto, PRT.
Cureus. 2025 Jul 1;17(7):e87122. doi: 10.7759/cureus.87122. eCollection 2025 Jul.
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by arterial, venous, or small-vessel thromboembolic events and/or pregnancy morbidity in the presence of antiphospholipid antibodies. APS can occur in the setting of an underlying systemic autoimmune disease, particularly systemic lupus erythematosus (SLE). SLE is a chronic autoimmune disease that can affect virtually any organ of the body due to the production of antinuclear antibodies. During the course of their disease, many patients develop pulmonary manifestations, including alveolar hemorrhage. We describe a clinical case of a 35-year-old woman with APS and SLE, anticoagulated with warfarin, who went to the emergency room with asthenia and productive cough with hemoptysis, and was diagnosed with a lupus flare and pulmonary-renal syndrome. Anticoagulation had to be discontinued due to the high risk of recurrent bleeding (HAS-BLED score 3). This case report describes the difficulty in managing the anticoagulant therapy in a patient with APS and SLE with both thrombotic and hemorrhagic manifestations.
抗磷脂综合征（APS）是一种自身免疫性疾病，其特征为在存在抗磷脂抗体的情况下发生动脉、静脉或小血管血栓栓塞事件和/或妊娠并发症。APS可发生于潜在的全身性自身免疫性疾病背景下，尤其是系统性红斑狼疮（SLE）。SLE是一种慢性自身免疫性疾病，由于抗核抗体的产生，实际上可累及身体的任何器官。在疾病过程中，许多患者会出现肺部表现，包括肺泡出血。我们描述了一例35岁患有APS和SLE的女性临床病例，该患者正在接受华法林抗凝治疗，因乏力、咳痰伴咯血前往急诊室，被诊断为狼疮发作和肺肾综合征。由于再次出血风险高（HAS - BLED评分3分），不得不停用抗凝治疗。本病例报告描述了在一名同时具有血栓形成和出血表现的APS和SLE患者中管理抗凝治疗的困难。
