Dorsolateral medullary infarction during skin infection by Stenotrophomonas maltophilia in a patient with triple antiphospholipid antibody positivity: a case-based review

Chen, Yu-Lan1; Yang, Hai-Tao1; Liu, Li-Xiong1; Chen, Cui-Hong1; Huang, Qin1; Hong, Xiao-Ping1; Zhao, Jiu-Liang2; Liu, Dong-Zhou1

2020-11-05

10.1007/s10067-020-05489-3

CLINICAL RHEUMATOLOGY   影响因子和分区

0770-3198

1434-9949

Thrombotic events are the most frequent causes of death in patients with antiphospholipid syndrome (APS). Previous studies have reported infection to be the most important trigger of thrombosis in APS, with molecular mimicry considered to be a major mechanism. Although timely management of infections has been recommended in patients with high suspicion of infection, anti-infective therapy would not take effect in a short time due to the dilemma in determining the origins of infection, especially in patients undergoing immunosuppressive therapy. Here, we describe a 26-year-old patient with systemic lupus erythematosus with triple antiphospholipid antibody positivity who had a stroke involving her dorsolateral medulla, despite timely anti-infective treatment within the context of skin infection caused by Stenotrophomonas maltophilia. To the best of our knowledge, it is the first report about the association between Stenotrophomonas maltophilia infection and thrombotic complications in APS. Thus, solely focusing on anti-infective therapy by the current recommendation for the management of APS may be insufficient within the context of infection; early initiation of effective anticoagulation should also be suggested until the anti-infective therapy becomes effective, especially in patients with high-risk antiphospholipid antibody profiles, in whom the potential benefit would outweigh the risk of bleeding.

Anticoagulation Antiphospholipid syndrome Dorsolateral medulla infarction High risk Infection

SCI

英语

第一 ; 通讯

Sanming Project of Medicine in Shenzhen[SYJY201901] ; National Natural Science Foundation of China[81971464] ; National Key Research and Development Program of China[2019YFC0840600]

Rheumatology

Rheumatology

WOS:000587147400005

SPRINGER LONDON LTD

CLINICAL MEDICINE

Web of Science

1.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen Peoples Hosp, Dept Rheumatol & Immunol,Jinan Univ,Clin Med Coll, Shenzhen 518020, Peoples R China
2.Peking Union Med Coll & Chinese Acad Med Sci, Natl Clin Res Ctr Dennatol & Immunol Dis NCRC Did, Dept Rheumatol & Clin Immunol, Peking Union Med Coll Hosp, Beijing 100730, Peoples R China

Chen, Yu-Lan,Yang, Hai-Tao,Liu, Li-Xiong,et al. Dorsolateral medullary infarction during skin infection by Stenotrophomonas maltophilia in a patient with triple antiphospholipid antibody positivity: a case-based review[J]. CLINICAL RHEUMATOLOGY,2020.

Chen, Yu-Lan.,Yang, Hai-Tao.,Liu, Li-Xiong.,Chen, Cui-Hong.,Huang, Qin.,...&Liu, Dong-Zhou.(2020).Dorsolateral medullary infarction during skin infection by Stenotrophomonas maltophilia in a patient with triple antiphospholipid antibody positivity: a case-based review.CLINICAL RHEUMATOLOGY.

Chen, Yu-Lan,et al."Dorsolateral medullary infarction during skin infection by Stenotrophomonas maltophilia in a patient with triple antiphospholipid antibody positivity: a case-based review".CLINICAL RHEUMATOLOGY (2020).