紅斑性狼瘡合併抗磷脂徵候群：一病例報告與文獻回顧

抗磷脂徵候群（antiphospholipid syndrome, APS），亦稱為抗牛心脂徵候群（anticardiolipin syndrome），是一種臨床上主要出現動靜脈栓塞、習慣性流產或血小板減少；並合併有抗磷脂抗體，如抗牛心脂抗體（anticardiolipin antibodies）與／或狼瘡抗凝物（lupus anticoagulants）存在的一種徵候群。本文報告一位39歲女性，因頭暈與下肢瘀斑住院。患者主訴近十年來一直持續有頭暈與下肢瘀斑，並且流產10多次。詳細詢問病史，發現患者亦有畏光及關節疼痛等症狀。曾經被告知有血小板減少，但未有明確之診斷。患者亦曾接受過類固醇治療，因不堪副作用而自行停藥。住院後經一系列檢查確定診斷為紅斑性狼瘡合併抗磷脂徵候群。之後患者接受靜脈注射類固醇治療，症狀明顯改善。抗磷脂徵候群是由抗磷脂抗體所引發的臨床徵候群。不同的抗磷脂抗體所引發的症狀不同，致病機轉亦不同，治療亦不同。因此正確的診斷抗磷脂徵候群是非常重要的。若能早期診斷並給予患者通常的治療一定可以避免栓塞及流產的復發，亦可使血小板增加。

關鍵字

抗磷脂徵候群；動靜脈栓塞；習慣性流產；血小板減少；抗磷脂抗體

並列摘要

Antiphospholipid syndrome (APS), also known as anticardiolipin syndrome, is characterized by arterial/venous thrombosis, recurrent spontaneous abortion, or thrombocytopenia; and associated with the presence of anti phospholipid antibodies, such as anticardiolipin antibodies and/or lupus anticoagulant. A 39-year-old females was admitted because of dizziness and low legs ecchymosis. These have bothered her for more than 10 years. Also, she had spontaneous abortion more than 10 times in recent 10 years. Besides, she had photophobia and arthritis also. She was told to have thrombocytopenia, but without received any further investigation and management. After admission, a series of examinations were done and the diagnosis of APS combined with systemic lupus erythematosus (SLE) was made. Then she received the steroid treatment, and the symptoms/signs improved. Awareness of the APS is very important. If patients with unexplained arterial/venous thrombosis, recurrent spontaneous abortion, or thrombocytopenia, the possibility of APS should be considered and anticardiolipin antibodies and/or lupus anticoagulant should be checked. Early diagnosis and early treatment, the patients with APS should have good prognosis.

並列關鍵字

antiphospholipid syndrome ； arterial/venous thrombosis ； recurrent spontaneous abortion ； thrombocytopenia ； antiphospholipid antibodies

國際替代計量

紅斑性狼瘡合併抗磷脂徵候群：一病例報告與文獻回顧

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