Severe limb necrosis: primary thrombotic microangiopathy or "seronegative" catastrophic antiphospholipid syndrome? A diagnostic dilemma.
Clin Rheumatol
; 26(10): 1737-40, 2007 Oct.
Article
en En
| MEDLINE
| ID: mdl-17256103
An episode of gastroenteritis triggered severe necrosis of all extremities in a previously asymptomatic male. Hepatic and renal involvement were also manifest, while the hematological picture was one of thrombotic microangiopathic hemolytic anemia. Antiphospholipid antibodies were negative. He responded well to a combination of plasma exchange, anticoagulation (heparin), parenteral steroids, and antibiotics, as well as vasodilators (prostacycline) and hyperbaric oxygen, but died because of a cerebral hemorrhage. The differential diagnosis included thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome, or seronegative catastrophic antiphospholipid (Asherson's) syndrome. The dangers of administering such a combination of therapies with anticoagulation, as well as vasodilatation (prostacycline) and hyperbaric oxygen, are highlighted by the case report and emphasized.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trombosis
/
Enfermedades Vasculares
/
Síndrome Antifosfolípido
/
Extremidades
/
Necrosis
Tipo de estudio:
Diagnostic_studies
Límite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Rheumatol
Año:
2007
Tipo del documento:
Article
País de afiliación:
Eslovaquia
Pais de publicación:
Alemania