tetano
Editor, Senior Moderator
J Blood Med
. 2021 Oct 30;12:929-933.
doi: 10.2147/JBM.S324873. eCollection 2021.
A Case Report of COVID-Associated Catastrophic Antiphospholipid Syndrome Successfully Treated with Eculizumab
Anusha Chidharla[SUP] 1 [/SUP], Salman B Syed[SUP] 2 [/SUP], Tulika Chatterjee[SUP] 2 [/SUP], Michael D Tarantino[SUP] 3 [/SUP]
Affiliations
Abstract
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by multiple episodes of venous and arterial thromboses or recurrent fetal losses in the presence of antiphospholipid antibodies against β[SUB]2[/SUB]GP1, frequently accompanied by moderate thrombocytopenia. Catastrophic APS (CAPS) is a severe manifestation of APS. COVID-19 may have an intense hypercoagulable state in critically ill patients. SARS-CoV2 may potentiate pathogenic APS effects, including the activation of endothelial cells, monocytes, platelets, and complement, resulting in a proinflammatory state and prothrombotic events. The endothelial tropism of SARS-CoV2 may also modify the clinical presentation of COVID-19 in susceptible individuals and trigger flares of underlying vascular diseases. We report a case of a 64-year-old woman with a history of triple-positive APS who had multiple thrombotic and bleeding episodes after being found to have a COVID-19 infection temporally associated with CAPS development that was successfully treated with eculizumab, preventing further macro- and microvascular thrombotic events at 1 month follow-up. Our case highlights the need for more research regarding the mechanism by which COVID-19 may potentiate APS and lead to the development of CAPS.
Keywords: COVID-19; antiphospholipid syndrome; catastrophic APS; eculizumab; phospholipid autoantibodies; severe acute respiratory syndrome coronavirus 2.
. 2021 Oct 30;12:929-933.
doi: 10.2147/JBM.S324873. eCollection 2021.
A Case Report of COVID-Associated Catastrophic Antiphospholipid Syndrome Successfully Treated with Eculizumab
Anusha Chidharla[SUP] 1 [/SUP], Salman B Syed[SUP] 2 [/SUP], Tulika Chatterjee[SUP] 2 [/SUP], Michael D Tarantino[SUP] 3 [/SUP]
Affiliations
- PMID: 34744467
- PMCID: PMC8566005
- DOI: 10.2147/JBM.S324873
Abstract
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by multiple episodes of venous and arterial thromboses or recurrent fetal losses in the presence of antiphospholipid antibodies against β[SUB]2[/SUB]GP1, frequently accompanied by moderate thrombocytopenia. Catastrophic APS (CAPS) is a severe manifestation of APS. COVID-19 may have an intense hypercoagulable state in critically ill patients. SARS-CoV2 may potentiate pathogenic APS effects, including the activation of endothelial cells, monocytes, platelets, and complement, resulting in a proinflammatory state and prothrombotic events. The endothelial tropism of SARS-CoV2 may also modify the clinical presentation of COVID-19 in susceptible individuals and trigger flares of underlying vascular diseases. We report a case of a 64-year-old woman with a history of triple-positive APS who had multiple thrombotic and bleeding episodes after being found to have a COVID-19 infection temporally associated with CAPS development that was successfully treated with eculizumab, preventing further macro- and microvascular thrombotic events at 1 month follow-up. Our case highlights the need for more research regarding the mechanism by which COVID-19 may potentiate APS and lead to the development of CAPS.
Keywords: COVID-19; antiphospholipid syndrome; catastrophic APS; eculizumab; phospholipid autoantibodies; severe acute respiratory syndrome coronavirus 2.