期刊
JOURNAL OF BLOOD MEDICINE
卷 12, 期 -, 页码 929-933出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/JBM.S324873
关键词
antiphospholipid syndrome; phospholipid autoantibodies; catastrophic APS; COVID-19; severe acute respiratory syndrome coronavirus 2; eculizumab
类别
Antiphospholipid syndrome (APS) and its severe manifestation Catastrophic APS (CAPS) may be affected in patients with COVID-19 infection, especially in critically ill cases. COVID-19 may exacerbate the pathological effects of APS, leading to the onset of vascular diseases.
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by multiple episodes of venous and arterial thromboses or recurrent fetal losses in the presence of antiphospholipid antibodies against beta(2)GP1, frequently accompanied by moderate thrombocytopenia. Catastrophic APS (CAPS) is a severe manifestation of APS. COVID-19 may have an intense hypercoagulable state in critically ill patients. SARS-CoV2 may potentiate pathogenic APS effects, including the activation of endothelial cells, monocytes, platelets, and complement, resulting in a proinflammatory state and prothrombotic events. The endothelial tropism of SARS-CoV2 may also modify the clinical presentation of COVID-19 in susceptible individuals and trigger flares of underlying vascular diseases. We report a case of a 64-year-old woman with a history of triple-positive APS who had multiple thrombotic and bleeding episodes after being found to have a COVID-19 infection temporally associated with CAPS development that was successfully treated with eculizumab, preventing further macro- and microvascular thrombotic events at 1 month follow-up. Our case highlights the need for more research regarding the mechanism by which COVID-19 may potentiate APS and lead to the development of CAPS.
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