Clinical case analysis—Jaundice, headache and projectile vomiting
10.3760/cma.j.cn141217-20240429-00143
- VernacularTitle:临床病例评析——皮肤巩膜黄染 头痛喷射性呕吐
- Author:
Zhejun XU
1
;
Can HUANG
;
Jiuliang ZHAO
;
Mingsheng MA
;
Mengtao LI
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院风湿免疫科 国家皮肤与免疫疾病临床医学研究中心 疑难重症及罕见病国家重点实验室 风湿免疫病学教育部重点实验室，北京 100730
- Publication Type:Journal Article
- Keywords:
Antiphospholipid syndrome;
Anemia, hemolytic, autoimmune;
Sinus thrombosis, intracranial
- From:
Chinese Journal of Rheumatology
2025;29(3):209-212
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To improve the clinical diagnostic ability of antiphospholipid syndrome (APS) with onset of autoimmune hemolytic anemia (AIHA).Methods:The diagnosis and treatment of one APS patient with AIHA as the initial manifestation were reported and discussed.Results:A young female patient admitted to Peking Union Medical College Hospital on October 15, 2022 suffered from AIHA and persistent lupus anticoagulant (LA) positivity. After being treated with high-dose glucocorticoid, both symptoms and indicators were improved. However, relapses occurred when the glucocorticoid was tapered. Subsequent attempts to combine multiple immunosuppressants and biologics for treatment was ineffective. During the course of the disease, the patient had experienced intermittent intracranial hypertension which was revealed as cerebral venous sinus thrombosis(CVST) by MRV. Laboratory test revealed that antiphospholipid antibodies and antiphospholipid serine/prothrombin antibodies (aPS/PT) were all positive. She was finally diagnosed with APS. After being treated with high-dose glucocorticoids and immunosuppressants, combined with warfarin and aspirin, the patient′s clinical symptoms were significantly improved.Conclusion:AIHA is one of the extra-criteria manifestations of APS. Patients with AIHA and persistent antiphospholipid antibody profiles should be alerted to the possibility of thrombotic events. It is difficult to control APS-CVST-AIHA patients′disease development and recurrence. Early and adequate antithrombotic therapy is essential for improvement of prognosis. Furthermore, some drugs may lead to false positive in LA testing, making aPS/PT a viable alternative method for assessing LA.
