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  • Clinical case of successful treatment of a patient with critical lower limb ischemia as a late onset of antiphospholipid syndrome

    Редактор | 2023, Clinical case, Practical medicine part 21 №3. 2023 | 19 июня, 2023

    I.M. SADREEVA2, A.A. SADREEVA1, A.V. MAKSIMOV2, 3

     1Republic Clinical Hospital, Kazan

    2I.M. Sechenov First Moscow State Medical University, Moscow

    3Kazan (Volga Region) Federal University, Kazan

    Contact details:

    Sadreeva I.M. — cardiologist of the Department of Vascular Surgery

    Address: 138 Orenburgskiy trakt, Kazan, Russian Federation, 420064, tel.: +7-917-269-25-12, e-mail: Ealmira.s@gmail.ru

    The antiphospholipid syndrome (APS) is characterized by non-inflammatory thrombotic vasculopathy with lesions of vessels of all types and localization. That is why clinical manifestations of APS are varied and patients turn to various physicians.

    The article describes a clinical case of a critical lower limb ischemia in AP. A 62 y. o. female patient was under outpatient observation for two years with the clinic of intermittent claudication and a diagnosis of atherosclerosis of lower limb arteries. At the same time, a history of thrombosis of the splenic artery — atypical for atherosclerosis, laboratory phenomena: a false-positive Wassermann reaction and an elongation of the phospholipid-dependent test (APTT) indicated APS. The patient was admitted into Department of Vascular Surgery of the Republic Clinical Hospital with critical lower limb ischemia and a threat of amputation. Antiphospholipid antibodies were detected. Due to the therapy pathogenetic for APS, amputation of the lower extremity was avoided.

    The presented clinical case shows that the APS may occur in people older than 60, and physicians of all specialties should be alert to this diagnosis.

    Key words: clinical case, antiphospholipid syndrome, thrombosis, critical lower limb ischemia, false positive Wasserman reaction, APTT prolongation.

    REFERENCES

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    2. Cohen H., Cuadrado M.J., Erkan D., Duarte-Garcia A. et al. 16th International Congress on Antiphospholipid Antibodies Task Force Report on Antiphospholipid Syndrome Treatment Trends. Lupus, 2020, vol. 29 (12), pp. 1571–1593. DOI: 10.1177/0961203320950461
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    5. Dabit J.Y., Valenzuela-Almada M.O., Vallejo-Ramos S. et al. Epidemiology of Antiphospholipid Syndrome in the General Population. Curr Rheumatol Rep, 2021, vol. 23, p. 85. DOI: 10.1007/s11926-021-01038-2
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    7. Rodríguez-Pintó I., Moitinho M., Santacreu I. et al. CAPS Registry Project Group (European Forum on Antiphospholipid Antibodies). Catastrophic antiphospholipid syndrome (CAPS): Descriptive analysis of 500 patients from the International CAPS Registry. Autoimmun Rev, 2016, vol. 15 (12), pp. 1120–1124. DOI: 10.1016/j.autrev.2016.09.010
    8. Bitsadze V.O., Khizroeva D.Kh., Idrisova L.E., Abramyan R.R., Andreeva M.D., Makatsariya A.D. Catastrophic antiphospholipid syndrome. Issues of pathogenesis. Akusherstvo, ginekologiya i reproduktsiya, 2015, no. 2, pp. 32–53 (in Russ.). DOI: 10.17749/2070-4968.2015.9.2.032-053

    Метки: 2023, A.A. SADREEVA, A.V. MAKSIMOV, antiphospholipid syndrome, APTT prolongation, Clinical case, critical lower limb ischemia, false positive Wasserman reaction, I.M. SADREEVA, Practical medicine part 21 №3. 2023, thrombosis

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