Presentación atípica de síndrome antifosfolípido
Palabras clave:
síndrome antifosfolípido, anticuerpos antifosfolípidos, oclusión venosa retiniana, amaurosis fugax
Resumen
El síndrome antifosfolípido es considerado un trastorno del colágeno asociado a presentaciones clínicas a edades intermedias con incidencias no mayores de 5 casos por cada 100.000 personas. Su espectro clínico oscila en la presencia de manifestaciones trombóticas multisistémicas de origen vascular. Sin embargo, las manifestaciones no vasculares tienen un espectro raro en su presentación habitual. Se presenta el caso de un varón de 64 años con manifestaciones oculares relacionadas a amaurosis fugaz asociado a alteraciones estructurales retinianas. Los hallazgos de tamizajes realizados fueron fuertemente sugestivos de trombofilias primarias. Se aplicó perfil para síndrome antifosfolípido el cual fue positivo, por lo que se instauró anticoagulación plena.
Citas
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2. Andreoli L, Chighizola CB, Banzato A, Pons-Estel GJ, Ramire de Jesus G, Erkan D. Estimated frequency of antiphospholipid antibodies in patients with pregnancy morbidity, stroke, myocardial infarction, and deep vein thrombosis: a critical review of the literature. Arthritis Care Res (Hoboken) [Internet]. 2013 [cited 2023 Nov 10];65(11):1869-73. Availablre from: https://acrjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/acr.22066. doi: 0.1002/acr.22066
3. Yang P, Kruh JN, Foster CS. Antiphospholipid antibody syndrome. Curr Opin Ophthalmol. 2012; 23 (6):528-32. doi: 10.1097/ICU.0b013e328358b937
4. Utz VM, Tang J. Ocular manifestations of the antiphospholipid syndrome. Br J Ophthalmol. 2011; 95(4):454-9. doi: 10.1136/bjo.2010.182857
5. Paccalin M, Manic H, Bouche G, Landron C, Mercié M, Boinot C, Gombert JM, Roblot P, Dighiero P. Antiphospholipid syndrome in patients with retinal venous occlusion. Thromb Res. 2006; 117(4):365-9. doi: 10.1016/j.thromres.2005.03.005
6. Zhu W, Wu Y, Xu M, Wang JY, Meng YF, Gu Z, Lu J. Antiphospholipid antibody and risk of retinal vein occlusion: a systematic review and meta-analysis. PLoS One [Internet]. 2015 [cited 2023 Nov 10];10(4): e0122814. Available from: https://pubmed.ncbi.nlm.nih.gov/25918850. doi: 10.1371/journal.pone.0122814
7. Keeling D, Mackie I, Moore GW, Greer IA, Greaves M. Guidelines on the investigation and management of antiphospholipidd syndrome. Br J Haematol [Internet]. 2012 [cited 2023 Nov 10]; 157(1):47-58. Available from: https://pubmed.ncbi.nlm.nih.gov/22313321. doi: 10.1111/j.1365-2141.2012.09037.x
8. Kumar K, Dan S, Sinha TK, Bhattacharya D. Severe vaso-occlusive retinopathy in systemic lupus erythematosus: A case series. Cureus [Internet]. 2021 [cited 2023 Nov 10];13(1): e13019. Available from: https://pubmed.ncbi.nlm.nih.gov/33665046. doi: 10.7759/cureus.13019
9. Tugcu B, Acar N, Coskun CT, Celik S, Yigit FU. Nonarteritic anterior ischemic optic neuropathy as the presenting manifestation of primary antiphospholipid syndrome. Indian J Ophthalmol [Internet]. 2014 [cited 2023 Nov 10];62(5):642–4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065524. doi: 10.4103/0301-4738.109535
10. Hernández JL, Sanlés I, Pérez-Montes R, Martínez-Taboada VM, Olmos JM, Salmón Z, et al. Antiphospholipid syndrome and antiphospholipid antibody profile in patients with retinal vein occlusion. Thromb Res. 2020; 190:63–8. doi: 10.1016/j.thromres.2020.04.005
11. Cho Y, Kim BS, Yoo WS, Seo SW, Chung IY. Antiphospholipid syndrome of bilateral nonarteritic anterior ischemic optic neuropathy patient deteriorating over time. Korean J Ophthalmol [Internet]. 2021 [cited 2023 Nov 10];35(2):168–70. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046616. doi: 10.3341/kjo.2020.0100
12. Choudhary RA, Siddiqui MAR, Moiz B, Ishaq S. Combined central retinal artery and vein occlusion associated with antiphospholipid syndrome. BMJ Case Rep [Internet]. 2022 [cited 2023 Nov 10];15(3): e248425. Available from: https://pubmed.ncbi.nlm.nih.gov/35246439. doi: 10.1136/bcr-2021-248425
13. Neto EDS, Neto TSR, Signorelli F, Balbi GGM, Higashi AH, Monteiro MLR, et al. Ocular retinal findings in asymptomatic patients with antiphospholipid syndrome secondary to systemic lupus erythematosus. Clin Rheumatol. 2023;42(8):2105–14
14. Pérez-Crespo A, Gutiérrez-Ortiz C. Retinal arterial and venous obstruction as the first manifestation of an antiphospholipid antibody syndrome. Arch Soc Esp Oftalmol (Engl Ed). 2021;96(7):380–3. doi: 10.1016/j.oftale.2020.06.010
15. Kim JH, Kang MH, Seong M, Cho H, Shin YU. Anomalous coagulation factors in non-arteritic anterior ischemic optic neuropathy with central retinal vein occlusion. Medicine (Baltimore) [Internet]. 2018 [cited 2023 Nov 10];97(15): e0437. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908582. doi: 10.1097/MD.0000000000010437
16. Beckhauser AP, Arana LA, Skare TL. Síndrome do anticorpo antifosfolípide causando oclusão bilateral de artérias e veias centrais da retina: relato de caso. Arq Bras Oftalmol [Internet]. 2008 [citado 10 Nov 2023];71(2):282–5. Disponible en: https://www.scielo.br/j/abo/a/MNkfjCCPfhjnP8gFKgmxfdj/#. doi: https://doi.org/10.1590/S0004-27492008000200029
