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Current management of catastrophic antiphospholipid syndrome

机译:灾难性抗磷脂综合征的当前管理

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摘要

The catastrophic variant of the antiphospholipid syndrome (APS) is the most severe form of APS with acute multiple organ involvement and small vessel thrombosis. At present, there are no studies on the pathophysiological mechanisms of catastrophic APS. The two theoretical explanations for the clinical manifestations of catastrophic APS are the development of thrombosis and the systemic inflammatory response syndrome (SIRS). From retrospective study data, first-line therapies should always include the combination of anticoagulation against thrombosis plus glucocorticoids against manifestations of SIRS plus plasma exchange and/or intravenous immunoglobulins to remove or block the antiphospholipid antibodies and cytokines involved in the SIRS. This review is focused on current management of catastrophic APS and some of the potential new therapeutic approaches.
机译:抗磷脂综合征(APS)的灾难性变体是最严重的APS形式,伴有急性多脏器受累和小血管血栓形成。目前,尚无关于灾难性APS的病理生理机制的研究。灾难性APS临床表现的两种理论解释是血栓形成和全身性炎症反应综合征(SIRS)。从回顾性研究数据来看,一线治疗应始终包括抗血栓形成的抗凝药物,针对SIRS表现的糖皮质激素,血浆置换和/或静脉内免疫球蛋白的组合,以去除或阻断SIRS中涉及的抗磷脂抗体和细胞因子。这项审查的重点是灾难性APS的当前管理和一些潜在的新治疗方法。

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