Sistemik Lupus Eritematozusa Bağlı Sekonder Antifosfolipid Antikor Sendromu: Superior Mezenterik Arter Tutulumuyla Seyreden Olgu Sunumu

Yıl 2024, Cilt: 8 Sayı: 1, 126 - 129, 29.04.2024

Beliz Karataş , İlker Yalçın , Neşe Çabuk Çelik , Gizem Pire , Hatice Şeyma Eren , Ali Sahin

https://doi.org/10.46332/aemj.1114233

Öz

Antifosfolipid antikor sendromu (AFAS); antifosfolipid protein antikor pozitifliği yanı sıra rekurren vasküler tromboz ve/veya gebelik kayıpları ile karakterize bir hastalıktır. Altta yatan bir hastalık saptanmadığında primer tip; altta yatan başka bir romatolojik hastalık varlığında sekonder tip olarak sınıflandırılır. Sekonder AFAS, en sık sistemik lupus eritematozusa (SLE) bağlı gelişir. Burada, AFAS’ta superior mezenterik arter tutulumuna bağlı iskemik kolit vakasını sunduk. 59 yaşında SLE tanısı bulunan kadın hastaya, ani gelişen hematokezya ve akut batın kliniği olması üzerine çekilen kontrastlı bilgisayarlı tomografi anjiografide (BT-anjiografi) superior mezenterik arterde tromboz saptandı. Bu olgu AFAS’a bağlı gastrointestinal sistemdeki farklı damar tutulumu ve tedavi stratejisi açısından ilginçti.

Anahtar Kelimeler

Anti-fosfolipid antikor sendromu, iskemik kolit, sistemik lupus eritematozus

Secondary Antiphospholipid Antibody Syndrome Due to Systemic Lupus Erythematosus: A Case Report with Superior Mesenteric Artery Involvement

Öz

Antiphospholipid antibody syndrome (APS); is a disease characterized by anti-phospholipid protein antibody positivity as well as recurrent vascular thrombosis and/or pregnancy loss. When no underlying disease is detected, it is classified as primary type; when there is another underlying rheumatologic disease, it is classified as secondary type. Secondary APS, most commonly develops due to systemic lupus erythematosus (SLE). We present a case of ischemic colitis due to superior mesenteric artery involvement in APS. 59-year-old female patient diagnosed with SLE had sudden-onset hematochezia and acute abdomen. Therefore, the patient underwent contrast-enhanced computed tomography angiography (CT angiography). Thrombosis was detected in the superior mesenteric artery. This case was interesting in terms of different vascular involvement and treatment strategy in the gastrointestinal tract due to APS.

Anahtar Kelimeler

Anti-phospholipid antibody syndrome, ischemic colitis, systemic lupus erythematosus

Kaynakça

• 1. Negrini S, Pappalardo F, Murdaca G, Indiveri F, Puppo F. The anti phospholipid syndrome: from pathophysiology to treatment. Clin Exp Med. 2017;17(3):257-267.
• 2. Pons-Estel GJ, Andreoli L, Scanzi F, Cervera R, Tincani A. The anti phospholipid syndrome in patients with systemic lupuserythematosus. J Autoimmün. 2017;76(1):10-20.
• 3. Uthman I, Noureldine MHA, Ruiz-Irastorza G, Khamashta M. Management of anti phospholipid syndrome. Ann Rheum Dis. 2019;78(2):155-161.
• 4. Uthman I, Khamashta M. The abdominal manifestations of the antiphospholipid syndrome. Rheumatology (Oxford). 2007;46(11):1641-1647.
• 5. Yayla ME, Yüksel M, Şahin D, et. al. Clinical Features of Patients with Anti phospholipid Syndrome and Differences of Patients with Recurrent Thrombosis, A Single Center Retrospective Study. J Ankara Univ Fac Med. 2021;74(1):52-59.
• 6. Bagger PV, Andersen V, Baslund B, et. al. Anti-cardiolipin Antibodies (IgG and IgA) in Women with Recurrent Fetal Loss Correlate to Clinical and Serological Characteristics of SLE. Acta Obstet Gynecol Scand. 1993;72(6):465-469.
• 7. England RJA, Woodcock B, Zeiderman MR. Superior Mesenteric Artery Thrombosis in a Patient with the Anti phospholipid Syndrome. Eur J Vasc Endovasc Surg. 1995;10(3): 372-373.
• 8. Kaushik S, Federle MP, Schur PH, Krishnan M, Silverman SG, Ros PR. Abdominal Thrombotic and Ischemic Manifestations of the Anti phospholipid Antibody Syndrome: CT Findings in 42 Patients. Radiology. 2001;218(3):768-771.
• 9. Kerzmann A , Haumann A , Boesmans E , Detry O, Defraigne JO. Acute mesenteric ischemia. Rev Med Liege. 2018;73(5-6):300-303.
• 10. Tektonidou MG, Andreoli L, Limper M, et. al. EULAR recommendations for the management of anti phospholipid syndrome in adults. Ann Rheum Dis. 2019;78(10):1296-1304.