[Paraneoplastic lupus anticoagulans syndrome].
The antiphospholipid antibody syndrome (Lupus anticoagulans syndrome) is a rare form of coagulopathy due to the presence of autoantibodies against phospholipids or phospholipid-binding protein cofactors that can lead to vascular thrombosis. We report the case of a 57-year-old female patient presenting with decompensated duodenal stenosis due to a pancreatic tumor. Perioperative testing of coagulation markers revealed with 26 % a strongly decreased Quick-Test and with 81.4 s a prolonged partial thromboplastin time that persisted despite intravenous application of 80 mg vitamin K (Konakion) and 10 units of fresh frozen plasma. Subsequent screening for common causes of thrombophilia revealed antiphospholipid antibodies. Consequently, low molecular weight heparin (Dalteparin-Natrium) was administered perioperatively while a gastroenterostomy with entero-enterostomy was performed with uneventful postoperative course. With this presentation and an analysis of the contemporary literature we would like to discuss different aspects of Lupus anticoagulans syndrome.
Korenkov
M
M
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität Mainz. korenkov@ach.klinik.uni-mainz.de
Depta
A
A
Kentner
R
R
Beck
J
J
Junginger
T
T
D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000175:diagnosis; D017985:Dalteparin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D016682:Lupus Coagulation Inhibitor; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D010257:Paraneoplastic Syndromes; D011182:Postoperative Care; D011300:Preoperative Care; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D016682:Lupus Coagulation Inhibitor; D017985:Dalteparin