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Revista Cubana de Reumatología

versão On-line ISSN 1817-5996

Resumo

MILIAN HERNANDEZ, Eduardo Josué; BETANCOURT CASTELLANOS, Liset  e  DAZA COELLO, Karla Michelle. Antiphospholipid syndrome, systemic lupus erythematosus and pulmonary thromboembolism. Case presentation. Rev Cuba Reumatol [online]. 2020, vol.22, n.3  Epub 01-Dez-2020. ISSN 1817-5996.

The antiphospholipid or Hughes syndrome, as it is also known, can appear in isolation or in association with other autoimmune diseases such as systemic lupus erythematosus. The association of both entities can cause various complications, such as pulmonary thromboembolism. We present the case of a 28-year-old patient, with a history of repeated abortions and stillbirth, admitted on this occasion due to deep vein thrombosis of the right upper limb, confirmed by Doppler ultrasound. The diagnosis of antiphospholipid syndrome secondary to systemic lupus erythematosus was confirmed, supported by the clinical and immune elements present. The patient evolved satisfactorily, with the therapeutic protocol used in the acute phase, where she initially received treatment with low molecular weight heparin of the type clexane (enoxaparin) 1 mg x kg every 12 hours, and discoumarin drugs of the warfarin type, which she currently maintains at a 5mg dose with an INR of 3. Initially prednisone was placed at a dose of 1mg x kg with good therapeutic response, currently maintaining a 10mg dose. He is also currently on hydroxychloroquine 200 mg daily.

Conclusions:

The importance of diagnosing the antiphospholipid syndrome is highlighted in all patients with spontaneous abortions or unexplained perinatal deaths. Treatment should be multidisciplinary and a systematic search for secondary conditions (particularly diffuse connective tissue diseases) should be conducted before qualifying the syndrome as primary.

Palavras-chave : antiphospholipid syndrome; systemic lupus erythematosus; pulmonary thromboembolism.

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