[Anesthetic implications in antiphospholipid syndrome. 2 clinical cases].
Anti-phospholipid syndrome, originally called anticardiolipin syndrome, is characterized by the presence of anti-phospholipid antibodies and a marked tendency to both arterial and venous thrombosis. The little information available on the implications of this syndrome for anesthesia derive from the recent description of the disease. We describe 2 patients, each with 1 of the 2 forms of antiphospholipid syndrome that have been described to date, and each needing surgery for a different reason. The first was a 24-year-old woman who was admitted to the hospital with diarrhea, fever and metrorrhagia in her fifth month of pregnancy. Blood tests revealed a weakly positive title of anti-cardiolipin antibodies. Steroid and antiplatelet therapy was begun. Delivery was at 35 weeks by elective cesarean with epidural anesthesia due to oligoamnios. The second patient was 52-year-old woman with a history of 13 miscarriages, cerebrovascular accident and deep venous thrombosis. She had been diagnosed as having systemic lupus erythematosus with anti-phospholipid syndrome and was receiving corticoid and antiplatelet therapy. She had been admitted on 2 occasions for epistaxis, purpura in the lower extremities and severe thrombocytopenia. The last condition did not respond well to immunosuppressant therapy and a splenectomy was therefore performed with the patient under general anesthesia. In both cases recovery was good in spite of the serious complications of anesthetic management.
Pallarés
J A
JA
Servicio de Anestesiología y Reanimación, Hospital Universitario de Valme, Sevilla.
Caba
F
F
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D016736:Antiphospholipid Syndrome / Q000188:drug therapy; D001327:Autoimmune Diseases / Q000188:drug therapy; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology; D013156:Splenectomy; D013921:Thrombocytopenia / Q000276:immunology / Q000601:surgery; D013924:Thrombophlebitis / Q000276:immunology
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors
Implicaciones anestésicas en el síndrome antifosfolípido. Dos casos clínicos.