高松动脉炎和抗磷脂综合征与严重血小板减少症的罕见关联

Abhijit Datta, Prayush Sharma, Shamim Ahmed, Syed Atiqul Haq
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摘要

高须动脉炎(TA)与抗磷脂综合征(APS)的关系在文献中很少被描述。本文报告了孟加拉国一名24岁妇女的首次记录的TA和APS病例。患者出现上肢和下肢跛行性疼痛4年,右手雷诺氏现象8个月。在她的病程中,她突然在左股浅静脉、腘静脉和胫骨后静脉形成深静脉血栓。常规血管造影显示右侧锁骨下动脉完全闭塞,右侧髂总动脉狭窄60-70%。右侧上肢CT血管造影显示右侧锁骨下动脉第2段壁增厚,右侧腋窝动脉第1段适度狭窄。她的抗心磷脂抗体持续呈高滴度阳性,狼疮抗凝剂(LA)阳性,活化的部分凝血活素时间(APTT)延长,严重的血小板减少症。我们开始使用大剂量强的松龙(每日1mg/kg)。她的血小板计数迅速增加。基于对10例病例报告的回顾,我们认为TA和APS罕见的关联。这两种情况都应及时确定,以便及早采取适当的治疗措施。Bangabandhu Sheikh Mujib Med. col。[j]; 2009;2(1): 59-63
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Rare Association of Takayasu Arteritis and Antiphospholipid Syndrome with Severe Thrombocytopenia
The association of Takayasu arteritis (TA) with antiphospholipid syndrome (APS) has rarely been described in the literature. This paper reports the first documented case of TA and APS in a 24-year-old woman in Bangladesh. This patient had claudication pain in upper and lower limbs for four years and Raynaud’s phenomenon in right hand for eight months. During the course of her illness, she suddenly developed deep vein thrombosis in left superficial femoral, popliteal and posterior tibial veins. Conventional angiography revealed total occlusion of right subclavian artery and 60-70% stenosis of right common iliac artery. CT angiography of right upper limb also supported these findings along with increased wall thickening in the 2nd part of right subclavian artery and moderate narrowing of the 1st part of right axillary artery. She had persistently positive anticardiolipin antibodies in high titers, positive lupus anticoagulant (LA), prolonged activated partial thromboplastin time (APTT) and severe thrombocytopenia. We started high dose prednisolone (1mg/kg daily). Her platelet count increased rapidly. Based on review of 10 case reports, we considered the rare association of TA and APS. Both conditions should be determined promptly for the sake of early institution of the appropriate therapy. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(1): 59-63
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