Catastrophic antiphospholipid syndrome during pregnancy
Background. Catastrophic antiphospholipid syndrome (CAPS) is the most severe form of antiphospholipid syndrome (APS) that manifests itself as multiple microthromboses in the microcirculatory bed of vital organs and as evolving multiple organ dysfunction in the presence of high titers of antiphospholipid antibodies (APA). CAPS is a life-threatening condition and requires emergency treatment. Unfortunately, the optimal treatment of CAPS has not been developed.Khizroeva D.Kh., Bitsadze V.O., Makatsaria A.D., Stulyova N.S.
A case report. Below is given a case of CAPS in a pregnant woman with complicated pregnancy and an elevated APA level. The patient has been under the authors’ scrutiny for subsequent 2 years. The authors observed her next pregnancy that was uneventful during anticoagulant therapy under constant control of the hemostatic system. Her pregnancy lasted 39 weeks and resulted in a natural delivery and the birth of a full-term living fetus.
Conclusion. The emergence of obstetric complications in female patients with APS is always suspicious of CAPS. Identification of APA should be mandatory in all pregnant women with preeclampsia, recurrent miscarriage, and early signs of pyoseptic diseases. This will assist in timely establishing the diagnosis of CAPS and in immediately initiating the currently developed optimal therapy.
Keywords
antiphospholipid syndrome
rare disease
thrombotic storm
catastrophic antiphospholipid syndrome
Supplementary Materials
- Fig. 1. Epitope of domain I of b2-glycoprotein I
- Fig. 2. Pathogenesis of CAPS (Asherson R., Makatsariya A.)
References
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Received 03.11.2016
Accepted 11.11.2016
About the Authors
Jamilya Khizroeva, MD, PhD, assistant of the Chair of Obstetrics and Gynecology of Medical Prophylaxis Faculty of I.M. Sechenov First Moscow State Medical University. 109004, Russia, Moscow, Zemlyanoi Val, 62. Tel.: +79153619073. E-mail: totu1@yandexViktoriya Bitsadze, MD, PhD Professor of the Chair of Obstetrics and Gynecology of Medical Prophylaxis Faculty of I.M. Sechenov First Moscow State Medical University. 109004, Russia, Moscow, Zemlyanoi Val, 62. Tel.: +79262313829. E-mail: vikabits@mail.ru
Alexander Makatsariya, MD, PhD Professor, Correspondent Member of the Russian Academy of Sciences, Head of the Chair of Obstetrics and Gynecology of Medical Prophylaxis Faculty of I.M. Sechenov First Moscow State Medical University, Vice-President of Russian Association of Obstetricians and Gynaecologists.
109004, Russia, Moscow, Zemlyanoi Val, 62. Tel.: +79037280897. E-mail: gemostasis@mail.ru
Stulyova Nadezhda Sergeevna, PhD, vice-principal of the Department “Clinical hemostasis” of I.M. Sechenov First Moscow State Medical University.
109004, Russia, Moscow, Zemlyanoi Val, 62. Tel.: +79262339619. E-mail: stulevans@mail.ru
For citations: Khizroeva D.Kh., Bitsadze V.O., Makatsaria A.D., Stulyova N.S. Catastrophic antiphospholipid syndrome during pregnancy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (7): 155-60. (in Russian)
http://dx.doi.org/10.18565/aig.2017.7.155-60
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