Calderón VG, Cordero AM

Language: Spanish
References: 13
Page: 42-47
PDF size: 131.52 Kb.

ABSTRACT

The antiphospholipid syndrome is a systemic autoimmune disease, orchestrated by multiple autoantibodies directed against phospholipid binding proteins. The disease has diverse clinical manifestations, in which thrombotic events and obstetric complications stand out. Current pharmacological treatment of obstetric antiphospholipid syndrome is oriented towards preventive methods, nonetheless, a considerable number of patients develop clinical manifestations despite optimal pharmacological measures. The current case report deals about a 24-year-old patient with a recent diagnosis of antiphospholipid syndrome who, despite treatment with low dose aspirin, heparin at full therapeutic dose and hydroxychloroquine, eventually develops severe preeclampsia and pregnancy interruption through an emergency c-section.

REFERENCES

1. Tektonidou M, Andreoli L, Limper M et al. EULAR recommendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis 2019;78(10):1296-1304.

2. Noureldine M, Nour-Eldine W, Khamashta M, Uthman I. Insights into the diagnosis and pathogenesis of the antiphospholipid syndrome. Semin Arthritis Rheum 2019;48(5):860-866,

3. Garcia D, Erkan D. Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med 2018; 378:2010-2021.

4. Bijlsma J, Hachulla E, da Silva J et al. Eular Textbook on Rheumatic Diseases. 3rd ed. London: European League Against Rheumatism; 2018.

5. Antovic A, Sennström M, Bremme K, Svenungsson E. Obstetric antiphospholipid syndrome. Lupus Sci Med 2018;5(1):e000197.

6. Marchetti T, Cohen M, de Moerloose P. Obstetrical Antiphospholipid Syndrome: From the Pathogenesis to the Clinical and Therapeutic Implications. Clin Dev Immunol; 2013:1-9.

7. Yelnik C, Laskin C, Porter T et al. Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients: validation of PROMISSE study results. Lupus Sci Med 2016;3(1):e000131.

8. Galarza-Maldonado C, Kourilovitch M, Pérez- Fernández O et al. Obstetric antiphospholipid syndrome. Autoimmun Rev 2012;11(4):288-295.

9. Tektonidou M, Andreoli L, Limper M, Tincani A, Ward M. Management of thrombotic and obstetric antiphospholipid syndrome: a systematic literature review informing the EULAR recommendations for the management of antiphospholipid syndrome in adults. RMD Open 2019;5(1):e000924.

10. Dobrowolski C, Erkan D. Treatment of antiphospholipid syndrome beyond anticoagulation. Clin Immunol 2019;206:53-62.

11. El-Haieg D, Zanati M, El-Foual F. Plasmapheresis and pregnancy outcome in patients with antiphospholipid syndrome. Int J Gynaecol Obstet 2007;99(3):236-241.

12. Ruffatti A, Favaro M, Hoxha A et al. Apheresis and intravenous immunoglobulins used in addition to conventional therapy to treat high-risk pregnant antiphospholipid antibody syndrome patients. A prospective study. J Reprod Immunol 2016;115:14- 19.

13. Schreiber K Hunt B. Managing antiphospholipid syndrome in pregnancy. Thromb Res 2019;181:S41-S46.