Anticoagulation in a patient with thrombocytopenia Secondary to antiphospholipid syndrome: Case Report
Journal Title: Revista Cuarzo - Year 2019, Vol 25, Issue 2
Abstract
Introduction. In the context of primary antiphospholipid syndrome (APS), thrombocytopenia, paradoxically, doesn’t suggest bleeding but thrombosis and it can progress to a catastrophic APS, a disease with elevated mortality. For that, in cases of APS with thrombocytopenia, the anticoagulation should not be differed, instead is the immediate treatment. Next is described a case of APS in a 20-year-old man with epistaxis, gingival bleeding, dyspnea, hemoptysis and ecchymosis in left inferior limb, with history of pulmonary thromboembolism (PTE) secondary to DVT 2 years ago, so he was anticoagulated with coumarin that was stopped 6 months ago due to administrative procedures. A PTE was considered so enoxaparin is started, and tests were ordered to clarify the etiology. The angiotac confirms the diagnosis and inferior limbs Doppler rules out DVT. Furthermore, a primary APS is confirmed and there is noted a severe thrombocytopenia unexpected for this pathology, that is why anticoagulation is discussed, weighing risk- benefit. In addition, due to autoimmune etiology, methylprednisolone, azathioprine and hydroxychloroquine was started with clinical and paraclinical improvement, achieving bridge therapy to coumarin satisfactorily, being possible to discharge the patient with warfarin,oral corticosteroid, azathioprine and hydroxychloroquine. Based on the exposed case, we affirm that patients with APS and thrombocytopenia must be anticoagulated as soon as possible.
Authors and Affiliations
Pedraza Arévalo, L. , Fajardo, Y. , & Guzmán, R
Keywords
Related Articles
- EP ID EP694667
- DOI https://doi.org/10.26752/cuarzo.v25.n2.445
- Views 137
- Downloads 0
Prevalence of risk factor for Klebsiella pneumoniae carbapenemic-resistant in-fection in adults in a fourth level hospital, Bogota.
Introduction: Gram-negative infections acquired in the hospital are an important cause of death, Klebsiella pneumoniae is one of the most significant bacteria, it is also related to the appearance of new mechanisms of an...
Knowledge, acttitudes, practices and dengue under registration Tocaima, Cundinamarca 2019
Introduction. Despite the surveillance strategies, it is believed that there is an underreporting of dengue, which may be secondary to the non-detection of cases, either due to non-consultation of the patient, due to fai...
TUBERCULOUS SPONDYLODISCITIS
The case of a 63-year old man with low back pain symptoms and occasional fever spikes which lasted forty-five days, is presentad. The patient was treated with antibiotics and pain killers in different health centers, and...
The doctor patient relationship process view from communications
Comunication between the patient and the health team is much more than the content of the interview. The simple reve¬lation of the information is just one small part of the complex communication process. There is a varie...
Syndrome febril unknown, high probability of brucellosis, case report
Brucellosis, caused by the gram negative bacterium Brucella spp, is one of the great imitators in the world of infectious diseases, can simulate various multisystem diseases, exhibit a broad clinical poly-morphism that f...