RESUMEN
Hypoprothrombinemia-lupus anticoagulant syndrome (HLAS) is a rare disease in which patients present with varying degrees of bleeding and positive lupus anticoagulant with reduced prothrombin on laboratory tests. This article reports a case of HLAS in a middle-aged woman with recurrent gingival bleeding and epistaxis as the first presentation. After admission, tests revealed prolonged prothrombin time (PT), activated partial thromboplastin time (APTT), and reduced coagulation factor II activity, and positive lupus anticoagulant (LA). Meanwhile, the patient had symptoms of dry mouth and dry eyes for a long time, and the examination of autoantibodies, tear secretion test and salivary gland emission computed tomography (ECT) were consistent with the diagnosis of Sjogren's syndrome. The final diagnosis was HLAS secondary to Sjogren's syndrome. After treatment with methylprednisolone and cyclophosphamide, the coagulation disorder gradually improved, and no recurrent bleeding occurred. HLAS is a rare clinical case, which reminds medical staff to be alert to the possibility of HLAS when encountering patients with unexplained prolonged APTT and PT and positive lupus anticoagulant.
Asunto(s)
Trastornos de la Coagulación Sanguínea Heredados , Hipoprotrombinemias , Síndrome de Sjögren , Persona de Mediana Edad , Femenino , Humanos , Hipoprotrombinemias/complicaciones , Hipoprotrombinemias/diagnóstico , Síndrome de Sjögren/complicaciones , Síndrome de Sjögren/diagnóstico , Inhibidor de Coagulación del Lupus , AutoanticuerposRESUMEN
Microplastics, plastic particles and fragments smaller than 5 mm are ubiquitous in various aquatic environments, but the hazards of microplastics with different particle sizes, concentrations and materials are not well understood. This study investigated the toxicity of polyethylene microplastics (PE-MPs) with different concentrations and particle sizes or polystyrene microplastics (PS-MPs) on freshwater algae Chlorella vulgaris Beij (C. vulgaris) for 11 days. Results indicated that the growth, colony formation, photosynthetic pigment contents and soluble intracellular polysaccharides were unaffected, whereas the photosynthetic efficiency and the total soluble protein (TSP) contents were remarkably decreased at 11 d with the increased concentration of PE-MP exposure. The growth, photosynthetic efficiency, soluble intracellular polysaccharides and TSP contents were unaffected after exposure to PE-MPs with different particle sizes or PS-MPs. By contrast, the colony formation and photosynthetic pigment contents were remarkably decreased after exposure to PS-MPs compared with the control or PE-MPs with the same particle size. The C. vulgaris colonization on microplastics was proven by scanning electron microscopy, indicating that the adsorption effects were the main harmful pathways of different microplastics to algal. Our results suggested that microplastics have limited harmful effects on algae, mainly in adsorption and shading.