Kaplan B, Cooper J, Lager D, Abecassis M
Department of Medicine, Northwestern University, Chicago, IL, USA.
Am J Kidney Dis. 1995 Nov;26(5):785-7. doi: 10.1016/0272-6386(95)90443-3.
Hepatic infarction remains a rare and dramatic presentation of an acute abdomen in patients with systemic lupus erythematosus. It can be recognized preoperatively only with a high index of suspicion. Imaging studies such as abdominal computed tomography may aid in making the diagnosis. The tendency for thrombosis in these patients often can be associated with the presence of circulating anticoagulants from a group of antiphospholipid antibodies. The finding of lupus anticoagulant or anticardiolipin antibodies can help identify those patients more prone to thrombotic episodes, although at present it cannot be assumed that these antibodies cause the thromboses. Hemodialysis patients are said to have a decreased tendency for vascular thrombosis, but this may not be true in the presence of circulating antiphospholipid antibodies. We report a case of histologically documented hepatic infarction secondary to thrombosis in an end-stage renal disease patient on hemodialysis with systemic lupus erythematosus and a circulating lupus anticoagulant.
肝梗死在系统性红斑狼疮患者中仍然是一种罕见且严重的急腹症表现。术前只有高度怀疑才能识别。腹部计算机断层扫描等影像学检查可能有助于做出诊断。这些患者的血栓形成倾向通常可能与一组抗磷脂抗体产生的循环抗凝物质有关。狼疮抗凝物或抗心磷脂抗体的检测有助于识别那些更容易发生血栓形成的患者，尽管目前不能认为这些抗体导致了血栓形成。据说血液透析患者血管血栓形成倾向降低，但在存在循环抗磷脂抗体的情况下可能并非如此。我们报告一例组织学证实的肝梗死病例，该病例发生在一名患有系统性红斑狼疮且存在循环狼疮抗凝物的终末期肾病血液透析患者中，肝梗死继发于血栓形成。
