[Seronegative antiphospholipid syndrome, catastrophic syndrome, new anticoagulants: learning from a difficult case report]. / Syndrome des antiphospholides "séronégatif ", syndrome catastrophique, nouveaux anticoagulants: enseignements d'une observation de prise en charge difficile.
Rev Med Interne
; 35(11): 752-6, 2014 Nov.
Article
em Fr
| MEDLINE
| ID: mdl-25217794
ABSTRACT
INTRODUCTION:
The diagnosis of the antiphospholipid syndrome (APS) is based on clinical and biological criteria including the persistent presence of antiphospholipid antibodies and thrombotic events or pregnancy morbidity. Heparins relayed by vitamin K antagonists (VKA) are the gold standard treatment for thrombosis. CASE REPORT We report a 17-year-old man who presented with an initially seronegative antiphospholipid syndrome, in whom the diagnosis was late, only obtained after anticoagulation withdrawing, when a catastrophic antiphospholipid syndrome (CAPS) with cutaneous lesions and disseminated intravascular coagulation syndrome occurred. For personal convenience, this patient was initially treated with fondaparinux followed by a new oral anticoagulant (rivaroxaban) before to return to the conventional VKA treatment.CONCLUSION:
The "seronegative" APS is a controversial concept reflecting the heterogeneity of antigenic targets for aPL. This diagnosis may be considered after a rigorous work-up, with the help of haemostasis laboratories testing new emerging aPL assays. In APS, the new anticoagulants represent an attractive option needing nevertheless prospective studies to evaluate their safety and efficacy. Lupus anticoagulant detection in patients treated by new oral anticoagulants is not easy by usually recommended coagulation tests.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome Antifosfolipídica
/
Anticorpos Antifosfolipídeos
/
Coagulação Intravascular Disseminada
Tipo de estudo:
Observational_studies
Limite:
Adolescent
/
Humans
/
Male
Idioma:
Fr
Revista:
Rev Med Interne
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
França