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CC BY 4.0 · TH Open 2020; 04(03): e207-e210
DOI: 10.1055/s-0040-1716735
Case Report

Flare of Antiphospholipid Syndrome in the Course of COVID-19

Alexandre Thibault Jacques Maria
1   Department of Internal Medicine–Multi-organ Diseases, Local Referral Center for Auto-immune Diseases, Montpellier School of Medicine, Saint-Eloi University Hospital, University of Montpellier, Montpellier, France
2   IRMB, Inserm U1183, CHU Montpellier (Saint-Eloi University Hospital), University of Montpellier, Montpellier, France
,
Isabelle Diaz-Cau
3   Hemostasis Laboratory, Referral Center for Hemophilia, Montpellier University Hospital, Saint-Eloi University Hospital, Montpellier, France
,
Jean-Marc Benejean
4   Department of Radiology, Narbonne Hospital, Narbonne, France
,
Anaïs Nutz
5   Department of Medicine and Endocrinology, Narbonne Hospital, Narbonne, France
,
Aurélie Schiffmann
1   Department of Internal Medicine–Multi-organ Diseases, Local Referral Center for Auto-immune Diseases, Montpellier School of Medicine, Saint-Eloi University Hospital, University of Montpellier, Montpellier, France
,
Christine Biron-Andreani
3   Hemostasis Laboratory, Referral Center for Hemophilia, Montpellier University Hospital, Saint-Eloi University Hospital, Montpellier, France
,
Philippe Guilpain
1   Department of Internal Medicine–Multi-organ Diseases, Local Referral Center for Auto-immune Diseases, Montpellier School of Medicine, Saint-Eloi University Hospital, University of Montpellier, Montpellier, France
2   IRMB, Inserm U1183, CHU Montpellier (Saint-Eloi University Hospital), University of Montpellier, Montpellier, France
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Abstract

We report the case of a 48-year-old man followed since 2013 for primary antiphospholipid syndrome (APLS) revealed by venous thromboembolism in the presence of antiphospholipid antibodies (APL-Abs, anticardiolipin and anti-β-2-glycoprotein-1), who decompensated in the course of coronavirus disease (COVID-19). Despite efficient anticoagulation, he suffered bilateral adrenal glands hemorrhage and limb arterial ischemia. The tropism of severe acute respiratory syndrome coronavirus-2 for endothelium can lead to microangiopathy and increased risk for thrombosis. If APL-Abs positivity can be an epiphenomenon under inflammatory and prothrombotic conditions, COVID-19 was herein responsible for disseminated thrombosis and a threat of catastrophic APLS, despite efficient anticoagulation.

Keywords

COVID-19 - infection - thrombosis - antiphospholipid syndrome - hydroxychloroquine

Authors' Contributions

Each author contributed to the patient care. A.T.J.M. and P.G. wrote the first draft, and all the authors proofread it. The same was accepted in its last version.




Publication History

Received: 03 May 2020

Accepted: 12 August 2020

Article published online:
11 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

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