[Urologic damage of the primary antiphospholipid syndrome].
OBJECTIVE
To perform a review and update of the antiphospholipid syndrome summarizing its urological presentations.


METHODS
A complete bibliographic search was performed through PubMed MEDLINE and articles were reviewed with special attention to those bibliographic references about urological presentations. We document the unique and unpublished case of a patient with neurogenic bladder secondary to antiphospholipid syndrome.


CONCLUSIONS
The antiphospholipid syndrome is an acquired autoimmune systemic disease generating a permanent hypercoagulability status with recurrent multiorgan thrombotic events due to circulating antiphospholipid antibodies. It may be secondary to a heterogeneous group of diseases (mainly lupus) and drugs, or primary if it appears isolated without any demonstrable systemic disease or concomitant medication. It is mainly characterized by venous or arterial recurrent thrombosis, recurrent abortion, thrombocytopenia, and circulating antiphospholipid auto-antibodies. Treatment with anticoagulants and correction of the hypercoagulable status contributing factors, arterial or venous thrombosis, and vascular risk aim to avoid new thrombosis episodes. Genitourynary system may be affected in any of its parts, generally by arterial or venous thrombosis. Kidney is the most frequently affected organ, in addition to transplanted kidney grafts, adrenal glands, bladder and testicles. There is a relationship between antiphospholipid syndrome and infertility. For the first time, we describe bladder involvement presenting as hyperreflexic neurogenic bladder with detrusor-sphincter dyssynergia after spontaneous spinal cord thrombosis in an asymptomatic adolescent with primary antiphospholipid syndrome which was unknown before.
Fernández Rosado
Enrique
E
Servicio de Urología, Complejo Hospitalario Universitario Juan Canalejo, La Coruña, España. efrosado@ozu.es
Sánchez Rodríguez-Losada
Javier
J
Alvarez Castelo
Luis
L
Blanco Diez
Antonio
A
Barbagelata López
Alfonso
A
Ponce Diaz-Reixa
Jose
J
Ruibal Moldes
Manuel
M
Novas Castro
Serafin
S
Chantada Abal
Venancio
V
González Martín
Marcelino
M
D000022:Abortion, Spontaneous / Q000209:etiology; D000293:Adolescent; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010879:Piperazines / Q000627:therapeutic use; D011247:Pregnancy; D011687:Purines; D000068677:Sildenafil Citrate; D012871:Skin Diseases / Q000188:drug therapy / Q000209:etiology; D013450:Sulfones; D013733:Testicular Diseases / Q000209:etiology; D001750:Urinary Bladder, Neurogenic / Q000209:etiology; D014570:Urologic Diseases / Q000209:etiology*
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate