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Recurrent Alveolar Hemorrhage and Pulmonary Capillaritis in the "Primary" Antiphospholipid Syndrome

 

作者: Ronald Asherson,   Michael Greenblatt,  

 

期刊: JCR: Journal of Clinical Rheumatology  (OVID Available online 2001)
卷期: Volume 7, issue 1  

页码: 30-33

 

ISSN:1076-1608

 

年代: 2001

 

出版商: OVID

 

关键词: Antiphospholipid syndrome;Adrenal infarction;Pulmonary hemorrhage and capillaritis;Avascular necrosis

 

数据来源: OVID

 

摘要:

Pulmonary involvement in the primary antiphospholipid syndrome (PAPS) has generally been on the basis of thromboembolism. We describe a patient with hemorrhagic alveolitis, a life-threatening complication that must also be considered. The patient was a 63-year-old Caucasian man who had a past history of recurrent deep vein thromboses as well as an arterial occlusion of the left popliteal artery and who developed hemorrhagic alveolitis and capillaritis at age 57 years, which was treated with long-term cyclophosphamide, steroids, and anticoagulation. Four years later, he had a recurrence of the same condition, and a positive lupus anticoagulant test was found. Severe thrombocytopenia, diagnosed as idiopathic thrombocytopenic purpura, was treated with platelet transfusions and increasing steroid dosage. Hemorrhagic adrenal infarction supervened at this time, and a septicemic illness was treated with intravenous antibiotics.Diffuse alveolar pulmonary hemorrhage is an unusual complication of the APS that is being increasingly reported, and recognition of its possible fatal course is of great importance for the treating physician. Severe thrombocytopenia that could contribute to hemorrhage may also accompany the APS, but this is unusual.

 

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