Catastrophic antiphospholipid syndrome during pregnancy
- Authors: Khizroeva D.K.1, Bitsadze V.O1, Makatsaria A.D1, Stulyova N.S.1
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Affiliations:
- I.M. Sechenov First Moscow State Medical University
- Issue: No 7 (2017)
- Pages: 155-160
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/248014
- DOI: https://doi.org/10.18565/aig.2017.7.155-60
- ID: 248014
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Abstract
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. 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 2years. 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.
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About the authors
D. Kh Khizroeva
I.M. Sechenov First Moscow State Medical University
Email: totul@yandex.ru
MD, PhD, assistant of the Chair of Obstetrics and Gynecology of Medical Prophylaxis Faculty
V. O Bitsadze
I.M. Sechenov First Moscow State Medical University
Email: vikabits@mail.ru
MD, PhD Professor of the Chair of Obstetrics and Gynecology of Medical Prophylaxis Faculty
A. D Makatsaria
I.M. Sechenov First Moscow State Medical University
Email: gemostasis@mail.ru
MD, PhD Professor, Correspondent Member of the Russian Academy of Sciences, Head of the Chair of Obstetrics and Gynecology of Medical Prophylaxis Faculty
Nadezhda Sergeevna Stulyova
I.M. Sechenov First Moscow State Medical University
Email: stulevans@mail.ru
PhD, vice-principal of the Department “Clinical hemostasis”
References
- Макацария А.Д., Бицадзе В.О., Хизроева Д.Х. Катастрофический антифосфолипидный синдром в акушерской практике. Журнал акушерства и женских болезней. 2012; 61(3): 7-21. [Makatsariya A.D., Bitsadze V.O., Khizroeva D.H. Catastrophic antiphospholipid syndrome in obstetrical practice. Zhurnal akusherstva i zhenskih bolezney. 2012; 61(3): 7-21. (in Russian)]
- Asherson R.A. The catastrophic antiphospholipid syndrome. J. Rheumatol. 1992; 19(4): 508-12.
- Asherson R.A. Multiorgan failure and antiphospholipid antibodies: the catastrophic antiphospholipid (Asherson’s) syndrome. Immunobiology. 2005; 210(10): 727-33.
- Asherson R.A., Cervera R., de Groot P.G., Erkan D., Boffa M.C., Piette J.C. et al. Catastrophic Antiphospholipid Syndrome Registry Project Group. Validation of the preliminary criteria for the classification of catastrophic antiphospholipid syndrome. Ann. Rheum. Dis. 2005; 64(8): 1205-9.
- Makatsariya N., Stuleva N., Khizroeva J. Multiple positivity and APA profile in women with fetal loss syndrome. In: Abstracts of the XXV Congress of the International Society on Thrombosis and Haemostasis. June 20-25, 2015. J. Thromb. Haemost. 2015; 13(Suppl. 2): PO052-MON.
- Tincani A., Andreoli L., Casu C., Cattaneo R., Meroni P. Antiphospholipid antibody profile: implications for the evaluation and management of patients. Lupus. 2010; 19(4): 432-5.
- Khizroeva J., Bitsadze V., Makatsariya N. Antiphospholipid antibodies circulation in patients undergoing IVF. In: Papers and Abstracts of the 6th International Symposium on Women’s Health Issues in Thrombosis and Haemostasis. February 13-5, 2015, Berlin, Germany. P-52.
- Бицадзе В.О., Хизроева Д.Х., Идрисова Л.Э., Абрамян Р.Р., Андреева М.Д., Макацария А.Д. Катастрофический антифосфолипидный синдром. Вопросы патогенеза. Акушерство, гинекология и репродукция. 2015; 9(2): 32-53. [Bitsadze V.O., Khizroeva D.H., Idrisova L.E., Abramyan R.R., Andreeva M.D., Makatsariya A.D. Catastrophic antiphospholipid syndrome. Questions of pathogenesis. Akusherstvo, ginekologiya i reproduktsiya. 2015; 9(2): 32-53. (in Russian)]
- Asherson R.A., Espinosa G., Cervera R., Gomez-Puerta J.A., Musuruana J., Bucciarelli S. et al. Disseminated intravascular coagulation in catastrophic antiphospholipid syndrome: clinical and haematological characteristics of 23 patients. Ann. Rheum. Dis. 2005; 64(6): 943-6.
- Макацария А.Д., Бицадзе В.О., Хизроева Д.Х. HELLP-синдром. Акушерство, гинекология и репродукция. 2014; 8(2): 61-6. [Makatsariya A.D., Bitsadze V.O., Khizroeva D.H. HELLP-syndrome. Akusherstvo, ginekologiya i reproduktsiya. 2014; 8(2): 61-6. (in Russian)]
- Kitchens C.S. Thrombotic storm: when thrombosis begets thrombosis. Am. J. Med. 1998; 104(4): 381-5.
- Хизроева Д.Х. Антифосфолипидные антитела и тромботический шторм. В кн.: Материалы XIII Всероссийского научного форума «Мать и Дитя». М.; 2011: 213-4. [Khizroeva D.H. Antiphospholipid antibodies and thrombotic storm. In: Materials of the XIII All-Russian Scientific Forum “Mother and Child”. Moscow; 2011: 213-4. (in Russian)]
- Makatsariya A.D., Bitsadze V.O, Khizroeva J.Kh. Thromboprophylaxis in pregnant women with a history of thrombophilia and thromboses. Curr. Prog. Obstet. Gynecol. 2013; 1:11-23.
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