RESUMEN
El síndrome antifosfolípido (SAF) fue descrito y caracterizado durante la segunda mi-tad del siglo XX inicialmente como un fenómeno protrombótico secundario en con-texto de otras enfermedades del tejido conectivo, principalmente lupus. Sin embargo, el estudio de pacientes con enfermedad primaria impulsó a distintos consensos, tan-to clínicos como de laboratorio para su correcta identificación. Entre los pacientes con SAF destaca la forma de presentación catastrófica, de baja prevalencia, pero impor-tante por su mal pronóstico, caracterizada por el compromiso de múltiples sistemas en corto tiempo. Presentamos el caso de una paciente del Hospital Clínico San Borja-Arriarán con diag-nóstico de SAF primario, que presentó en su evolución la forma catastrófica. Este caso sirve de base para una revisión del proceso diagnóstico del SAF en relación a otras patologías reumatológicas y las características propias del SAF catastrófico.
Antiphospholipid syndrome (APS) was described and characterized during the second half of the 20th century initially as a secondary prothrombotic phenome-non in the context of other connective tissue diseases, mainly lupus. However, the study of patients with primary disease prompted different consensus, both clin-ical and laboratory for their correct identification. Among patients with APS, the catastrophic presentation is of low prevalence, but important because of its poor prognosis, characterized by the commitment of multiple systems in a short time. We present the case of a patient from the San Borja-Arriaran Clinic Hospital with di-agnosis of primary APS, which presented the catastrophic form in its evolution. This case serves as a basis for a review of the diagnostic process of APS in relation to other rheumatologic pathologies and the characteristics of catastrophic APS.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Trombosis/etiología , Síndrome Antifosfolípido/complicaciones , Síndrome Antifosfolípido/terapia , Tomografía Computarizada por Rayos X , Síndrome Antifosfolípido/mortalidad , Síndrome Antifosfolípido/diagnóstico por imagen , Accidente Cerebrovascular , IsquemiaRESUMEN
The association between systemic lupus erythematosus and antiphospholipid syndrome can cause several complications. We report a 45 years old woman, treated with steroids for a systemic lupus erythematosus. She presented with a clinical picture of a lupus pneumonitis and, subsequently, with the picture of a pulmonary thromboembolism. The diagnosis was confirmed by helicoidal computed axial tomography. The patient was treated with anticoagulants, with a favourable outcome
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Embolia Pulmonar/etiología , Lupus Eritematoso Sistémico/complicaciones , Síndrome Antifosfolípido/complicaciones , Embolia Pulmonar/complicaciones , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamiento farmacológico , Prednisona/uso terapéutico , Heparina/uso terapéutico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Síndrome Antifosfolípido/tratamiento farmacológicoRESUMEN
Several diseases have been associated with hepatitis C virus infections, including rheumatologic, hematologic and neoplastic disorders. We report two women, aged 57 and 39 years old whom the initial presentation of hepatitis C virus infection was an arthritis resembling rheumatoid arthritis. Laboratory work up revealed abnormal liver function tests, stimulating the search for hepatitis C virus infection, having both patients positive ELISA tests. Detection of this agent is extremely important when selecting a therapy for the articular disease, since several drugs used in the treatment of rheumatic disorders are potentially hepatotoxic and immunosuppression is risky in the setting of a viral hepatitis