PDF(Pubmed)
Abstract：
Antiphospholipid syndrome (APS) is an uncommon autoantibody-mediated condition characterised by acquired thrombophilia resulting in recurrent arterial and venous thrombosis. An inciting factor allows for the exposure of endothelial phospholipids, causing antigen formation and subsequent creation of antibodies. A woman in her 70s presented after vehicular trauma, suffering broken ribs, pneumothorax and incidentally discovered left adrenal haemorrhage. Two weeks later she presented with acute-onset abdominal pain and was found to have a right adrenal gland haemorrhage on CT imaging without interval trauma occurring. The patient had antiphospholipid antibody laboratory studies drawn and was given intravenous heparin with a bridge to warfarin at discharge. Laboratory results returned positive for lupus anticoagulant, beta-2 glycoprotein and anticardiolipin antibodies indicating triple positivity, with repeated laboratory tests positive in 12 weeks\' time, confirming the diagnosis. Bilateral adrenal haemorrhage, rather than traditional venous thromboembolism, was the presenting pathology in this patient\'s diagnosis of APS.
摘要：
抗磷脂综合征（APS）是一种罕见的自身抗体介导的疾病，其特征是获得性血栓形成，导致反复的动脉和静脉血栓形成。一个激发因子允许内皮磷脂的暴露，导致抗原形成和随后产生的抗体。一名70多岁的妇女在车辆创伤后出现，肋骨骨折,气胸和偶然发现的左肾上腺出血。两周后，她出现了急性腹痛，在CT成像中发现右肾上腺出血，没有发生间隔创伤。该患者进行了抗磷脂抗体实验室研究，并在出院时给予静脉内肝素与华法林的桥接。实验室检查结果为狼疮抗凝物阳性,β-2糖蛋白和抗心磷脂抗体表明三阳性，在12周内反复进行实验室检查呈阳性，确认诊断。双侧肾上腺出血，而不是传统的静脉血栓栓塞，是该患者诊断为APS的病理表现。
