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Primary Antiphospholipid Syndrome Presenting With Life-Threatening Diffuse Alveolar Hemorrhage

2025-10Artigo científico Acesso aberto
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dc.contributor.authorCasanova Pinto, João
dc.contributor.authorCosta, Manuel G
dc.contributor.authorFernandes, Beatriz
dc.contributor.authorRamalheira, Carlos
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSpringer
dc.date.accessioned2026-04-23T12:37:01Z
dc.date.available2026-04-23T12:37:01Z
dc.date.issued2025-10
dc.descriptionCopyright © 2025, Casanova Pinto et al.
dc.description.abstractAntiphospholipid syndrome (APS)-associated diffuse alveolar hemorrhage (DAH) results from antiphospholipid-induced endothelial dysfunction, microvascular thrombosis, and complement activation. Management requires balancing thrombosis prevention and hemorrhage control. High-dose corticosteroids are the first-line therapy. We report a case of a 33-year-old male presenting with progressive dyspnea, hemoptysis, and hypoxemia. Initial evaluation revealed thrombocytopenia, anemia, elevated inflammatory markers, and diffuse bilateral ground-glass opacities on a thoracic computed tomography, consistent with DAH. Autoimmune serology confirmed persistent positivity for lupus anticoagulant, anti-cardiolipin IgM, and anti-β2-glycoprotein-I IgM, fulfilling APS classification criteria. The patient developed respiratory failure, requiring mechanical ventilation and venovenous extracorporeal membrane oxygenation (VV-ECMO). High-dose corticosteroids were initiated, leading to gradual improvement. He was successfully extubated and discharged on long-term anticoagulation with warfarin. At four years of follow-up, he remains free of APS-related complications. This case highlights the importance of recognizing APS as a cause of DAH, particularly in patients with unexplained pulmonary hemorrhage. Early diagnosis and aggressive therapy can improve outcomes.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1265532
dc.identifier.doi10.7759/cureus.93814
dc.identifier.issn2168-8184
dc.identifier.otherPURE: 161077965
dc.identifier.otherPURE UUID: 0f0b6c75-900a-49c6-9ed9-431869d8d3fa
dc.identifier.otherPubMed: 41189827
dc.identifier.otherPubMedCentral: PMC12580941
dc.identifier.urihttp://hdl.handle.net/10362/202501
dc.language.isoeng
dc.peerreviewedyes
dc.subject2023 acr/eular classification criteria
dc.subjectantiphospholipid antibody
dc.subjectantiphospholipid antibody syndrome (aps)
dc.subjectcatastrophic antiphospholipid antibody syndrome
dc.subjectdiffuse alveolar hemorrhage
dc.subjectprimary antiphospholipid antibody syndrome
dc.subjectpulmonary capillaritis
dc.subjectvenous thromboembolism
dc.titlePrimary Antiphospholipid Syndrome Presenting With Life-Threatening Diffuse Alveolar Hemorrhageen
dc.typejournal article
degois.publication.firstPage
degois.publication.issue10
degois.publication.lastPage
degois.publication.titleCureus
degois.publication.volume17
dspace.entity.typePublication
rcaap.rightsopenAccess

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