Antiphospholipid syndrome misdiagnosed as neuropsychiatric systemic lupus erythematosus:A case report and literature review
10.19845/j.cnki.zfysjjbzz.2024.0160
- VernacularTitle:抗磷脂综合征误诊为神经精神性狼疮1例并文献复习
- Author:
Qiang ZHANG
1
;
Nannan YU
;
Tianyuan ZHANG
Author Information
1. 中国人民解放军联勤保障部队第九六二医院中医风湿科,黑龙江 哈尔滨 150048
- Keywords:
Antiphospholipid syndrome;
Neuropsychiatric systemic lupus erythematosus;
Thrombocytope-nia;
Aspirin;
Indobufen
- From:
Journal of Apoplexy and Nervous Diseases
2024;41(9):839-842
- CountryChina
- Language:Chinese
-
Abstract:
When antiphospholipid syndrome(APS)and neuropsychiatric systemic lupus erythematosus(NPSLE)involve the central nervous system,the two diseases tend to have similar clinical symptoms and auxiliary examination re-sults and different diagnosis and treatment strategies,which may lead to potential misdiagnosis and mistreatment.This ar-ticle analyzes the causes of misdiagnosis and performs a literature review.A retrospective analysis was performed for one patient with thrombocytopenia and stroke as initial symptoms.The patient was initially diagnosed with NPSLE and was treated with hydroxychloroquine,glucocorticoids,mycophenolate mofetil to induce remission,and aspirin was given to prevent platelet aggregation.Subsequently,the patient developed a positive spectrum of antiphospholipid antibodies and venous thrombosis;therefore,the patient was diagnosed with APS and was given maintenance treatment with hydroxychlo-roquine and low-dose glucocorticoids and sequential therapy with low-molecular-weight heparin as an anticoagulant and in-dobufen for antiplatelet aggregation therapy.The patient had stable conditions without recurrence during follow-up for 5 months.Recognizing the initial symptoms and thrombotic events is crucial for the early diagnosis of APS and NPSLE.Fur-ther studies are needed to explore the long-term efficacy of indobufen as an alternative to aspirin in APS.
