• PDF / 169,824 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 24 Downloads / 142 Views

DOWNLOAD

REPORT

---

1 S

Lack of efficacy: case report A 48-year-old man exhibited lack of efficacy during treatment with enoxaparin sodium for antiphospholipid syndrome (APLS). The man, who had antiphospholipid syndrome characterised by venous thromboembolic event and nongenetic iron overload, was hospitalised for fever, cough and myalgia on 25 March 2020. He had been receiving fluindione since 2013 for APLS. He underwent venesection for nongenetic iron overload. After further examination, he was diagnosed with COVID-19 infection. He was started on an off-label treatment with hydroxychloroquine 400mg daily for 7 days, along with azithromycin 500mg on day 1 and 250mg for 4 days with low flow oxygen for a couple of days. On day 12 of hospitalisation, his fever and pulmonary functions improved. Thereafter, he suffered from sudden abdominal pain and had bilateral adrenal gland haemorrhage. As a result, his fluindione was discontinued and he was initiated on enoxaparin sodium 100 UI/kg twice daily [route not stated]. However, on day 17, painful acral ischaemic lesions showed dorsalis pedis artery occlusion. He did not have venous thromboembolic event (VTE); however, he was positive for lupus anticoagulant and antiphospholipid antibodies. An ALPS flare was suspected despite enoxaparin sodium therapy, and the COVID-19 infection. The man’s treatment with enoxaparin sodium was replaced with unfractionated heparin. Subsequently, there were no other clinical or radiological thrombotic events. Eventually on 16 April 2020, he was discharged under vitamin K antagonist and substitutive opotherapy for adrenal function. Maria ATJ, et al. Flare of antiphospholipid syndrome in the course of COVID-19. TH Open 4: E207-E210, No. 3, Jul 2020. Available from: URL: http://doi.org/10.1055/ 803518076 s-0040-1716735

0114-9954/20/1832-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 28 Nov 2020 No. 1832