ABSTRACT
We present a case in which transthoracic echocardiography was the first diagnostic tool to suspect mediastinal Hodgkin's lymphoma by revealing a change in the hemodynamic of left pulmonary artery flow, and it was used as a follow-up method for monitoring treatment efficacy by demonstrating a normalization of pulmonary artery hemodynamics
ABSTRACT
Objectives : To analyze clinical and immunologic manifestations of Lebanese patients with the antiphospholipid syndrome [APS]
Patients and Methods: Our study was retrospective and was done on hospitalized patients between 2001 and 2013. All these patients fulfilled the international criteria for diagnosis [Sydney criteria]
Results: Of the 30 patients selected, we noticed a female predominance [sex ratio: 2.75]. The age at diagnosis ranged between 9 and 72 years with a mean age of 43 +/- 17 years. "Primary" APS was present in 70% of patients; APS was associated with systemic lupus erythematosus [SLE] in 23% of patients, with a mixed connective tissue disease in 3% and systemic vasculitis in 3%. A catastrophic APS occurred in 3 cases [10%]. The most common presenting manifestations were deep venous thrombosis [53%], pulmonary embolism [33%] and stroke [13%]. Eleven patients [37%] had venous thrombosis, 7 [23%] had arterial thrombosis alone and 7 [23%] both arterial and venous thrombosis. Deep venous thrombosis occurred mostly in the lower limbs [70%] whereas arterial thrombosis occurred in cerebral arteries in 50% of cases. The most common fetal complications were early fetal loss [62.5%]. Anticardiolipin antibodies were the most frequently identified antibodies [83%], followed by anti-beta2GPI [70%] and anticoagulant lupus [11%]. An effective anticoagulation by anti-vitamin K was performed in 29 patients. Corticosteroids were prescribed in 13 cases and were associated to immunosuppressant drugs in 6 cases of secondary APS and the 3 catastrophic APS. The patients with catastrophic APS received also intravenous immunoglobulin. Response to treatment was favorable in 86% of patients with a mean follow up of 6 +/- 4 years. We deplored 4 deaths, 2 within the catastrophic APS
Conclusion: The APS does not seem to have particular features in Lebanon. The primary form seems to be the most common. It is important to diagnose this syndrome earlier before the onset of serious complications