Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients
Clinics
;
64(2): 79-82, 2009. tab
Article
Dans Anglais
| LILACS
| ID: lil-505367
ABSTRACT
OBJECTIVES:
To describe the clinical outcomes and thrombotic events in a series of critically ill cancer patients positive for antiphospholipid (aPL) antibodies.DESIGN:
Retrospective case series study.SETTING:
Medical-surgical oncologic intensive care unit (ICU). PATIENTS ANDPARTICIPANTS:
Eighteen patients with SIRS/sepsis and multiple organ failure (MOF) and positive for aPL antibodies, included over a 10-month period.INTERVENTIONS:
None MEASUREMENTS ANDRESULTS:
aPL antibodies and coagulation parameters were measured up to 48 hours after the occurrence of acrocyanosis or arterial/venous thrombotic events. When current criteria for the diagnosis of aPL syndrome were applied, 16 patients met the criteria for "probable" and two patients had a definite diagnosis of APL syndrome in its catastrophic form (CAPS). Acrocyanosis, arterial events and venous thrombosis were present in eighteen, nine and five patients, respectively. Sepsis, cancer and major surgery were the main precipitating factors. All patients developed MOF during the ICU stay, with a hospital mortality rate of 72 percent (13/18). Five patients were discharged from the hospital. There were three survivors at 90 days of follow-up. New measurements of lupus anticoagulant (LAC) antibodies were performed in these three survivors and one patient still tested positive for these antibodies.CONCLUSIONS:
In this small series of patients, we observed a high frequency of auto-antibodies and micro- and macro-vascular thrombotic events in critically ill cancer patients. The coexistence of sepsis or SIRS and aPL antibodies was often associated with MOF and death. More studies are necessary to determine the pathophysiological significance of antiphospholipid antibodies in severely ill cancer patients.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Lymphome malin non hodgkinien
/
Maladie grave
/
Anticorps antiphospholipides
/
Sepsie
/
Tumeurs gastro-intestinales
/
Défaillance multiviscérale
Type d'étude:
Etude diagnostique
/
Etude d'étiologie
/
Étude observationnelle
/
Facteurs de risque
Limites du sujet:
Adulte très âgé
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Clinics
Thème du journal:
Médicament
Année:
2009
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Instituto Nacional de Câncer/BR
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