‘Secondary’ Hughes (Antiphospholipid) Syndrome in Unusual Clinical Settings
| Autor: | M.A.F. Qurttom, M. Mourou, N. Abdella, A.N. Malaviya |
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| Rok vydání: | 1998 |
| Předmět: | |
| Zdroj: | Medical Principles and Practice. 7:134-141 |
| ISSN: | 1423-0151 1011-7571 |
| DOI: | 10.1159/000026034 |
| Popis: | Objectives and Importance: Hughes (antiphospholipid) syndrome is mainly seen among patients with systemic lupus erythematosus (SLE). This has been called ‘secondary’ in contrast to ‘primary’ where no obvious underlying disease is detectable. The objective of this report is to highlight the fact that Hughes syndrome can, however, also occur in association with other underlying diseases or, as a result of certain therapies. The importance of this report is in emphasizing the fact that secondary Hughes syndrome can occur in several settings other than SLE or SLE-like illness. Clinical Presentation: Here we describe 3 patients with clinical features of arterial or venous thromboses associated with significant levels of anticardiolipin antibodies. Their underlying diseases were, however, neither SLE nor ‘SLE-like’ illness. One of them had been on oral contraceptive pills, the 2nd patient had Behçet’s disease and the 3rd patient had liver carcinoma associated with hepatitis C infection. Thus, these patients could be classified under the category of ‘secondary’ Hughes (antiphospholipid) syndrome. Conclusion: The 1st patient recovered and remained well during a 12-month follow-up after the discontinuation of oral contraceptive pills combined with long-term low-dose aspirin therapy. The last patient remained normal in the 12-month follow-up period on long-term warfarin treatment at a dose adequate to keep the international normalized ratio above 3. The 2nd patient died of uncontrollable hypercoagulability associated with advanced extensive malignancy and related complications. It is, therefore, recommended that the possibility of Hughes syndrome be considered in any clinical situation characterized with hypercoagulable state. If proven, long-term anticoagulation may benefit the patient. |
| Databáze: | OpenAIRE |
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