Anticoagulation in a patient with thrombocytopenia Secondary to antiphospholipid syndrome: Case Report
Journal Title: Revista Cuarzo - Year 2019, Vol 25, Issue 2
Abstract
Introduction. In the context of primary antiphospholipid syndrome (APS), thrombocytopenia, paradoxically, doesn’t suggest bleeding but thrombosis and it can progress to a catastrophic APS, a disease with elevated mortality. For that, in cases of APS with thrombocytopenia, the anticoagulation should not be differed, instead is the immediate treatment. Next is described a case of APS in a 20-year-old man with epistaxis, gingival bleeding, dyspnea, hemoptysis and ecchymosis in left inferior limb, with history of pulmonary thromboembolism (PTE) secondary to DVT 2 years ago, so he was anticoagulated with coumarin that was stopped 6 months ago due to administrative procedures. A PTE was considered so enoxaparin is started, and tests were ordered to clarify the etiology. The angiotac confirms the diagnosis and inferior limbs Doppler rules out DVT. Furthermore, a primary APS is confirmed and there is noted a severe thrombocytopenia unexpected for this pathology, that is why anticoagulation is discussed, weighing risk- benefit. In addition, due to autoimmune etiology, methylprednisolone, azathioprine and hydroxychloroquine was started with clinical and paraclinical improvement, achieving bridge therapy to coumarin satisfactorily, being possible to discharge the patient with warfarin,oral corticosteroid, azathioprine and hydroxychloroquine. Based on the exposed case, we affirm that patients with APS and thrombocytopenia must be anticoagulated as soon as possible.
Authors and Affiliations
Pedraza Arévalo, L. , Fajardo, Y. , & Guzmán, R
Keywords
Related Articles
- EP ID EP694667
- DOI https://doi.org/10.26752/cuarzo.v25.n2.445
- Views 121
- Downloads 0
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