title: Catastrophic antiphospholipid syndrome triggered by fulminant disseminated herpes simplex infection in a patient with systemic lupus erythematosus.
abstract: Infections are considered one of the most common causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE), and occasionally can trigger a catastrophic antiphospholipid syndrome (APS). We describe a 22-year-old SLE patient with lupus nephritis under immunosuppressant therapy and asymptomatic carrier of antiphospholipid antibodies, who was admitted with tonsillitis and acute hepatitis, developing multiorgan failure in a few hours. Postmortem examination revealed hepatic necrosis, tonsillitis, pharyngitis and uterine cervicitis caused by herpes simplex virus (HSV) together with microthrombosis in lungs and glomerular arterioles, suggesting the diagnosis of fulminant HSV disseminated infection and catastrophic APS.
authors.affiliation: Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Catoggio
authors.forename: A
authors.initials: A
authors.lastname: Alvarez-Uría
authors.forename: P L
authors.initials: PL
authors.lastname: Fernandez
authors.forename: R
authors.initials: R
authors.lastname: Cervera
authors.forename: G
authors.initials: G
authors.lastname: Espinosa
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000276:immunology; D016736:Antiphospholipid Syndrome / Q000209:etiology / Q000276:immunology / Q000503:physiopathology*; D002388:Catastrophic Illness; D017809:Fatal Outcome; D005260:Female; D006561:Herpes Simplex / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008181:Lupus Nephritis / Q000150:complications / Q000188:drug therapy; D009102:Multiple Organ Failure / Q000209:etiology; D055815:Young Adult
chemical_list: D017152:Antibodies, Antiphospholipid; D007166:Immunosuppressive Agents