Open AccessAntiphospholipid Syndrome: primary or secondary to Systemic Lupus Erythematosus? Description of a clinical case of avitaminosis D in premenopausal woman with pseudo-Cushing syndrome
Author(s) -
Mauro Turrin,
Sergio Martinelli
Publication year - 2014
Publication title -
clinical management issues
Language(s) - English
Resource type - Journals
eISSN - 2283-3137
pISSN - 1973-4832
DOI - 10.7175/cmi.v8i2.912
Subject(s) - medicine , hydroxychloroquine , antiphospholipid syndrome , vitamin d and neurology , thrombosis , systemic lupus erythematosus , regimen , venous thrombosis , gastroenterology , surgery , disease , covid-19 , infectious disease (medical specialty)
Low vitamin D levels have been described in obese individuals and in some autoimmune diseases, such as Systemic Lupus Erythematosus (SLE) and primary antiphospholipid syndrome (pAPS). In particular, more than 50% of premenopausal women with pAPS have hypovitaminosis D. In this issue we report a case of an obese, premenopausal, and hypertensive woman with pseudo-Cushing syndrome, affected by deep venous thrombosis associated with pulmonary embolism after rib fracture who presented hypovitaminosis D. 7 years before, diagnosis of pAPS had been made after the detection of thrombocytopenia (present at a young age) and arterial ischemia of a lower limb. For seven years she was treated with acetylsalicylic acid without complications. We found positive anti-dsDNA antibodies, a triple antiphospholipid antibodies (aPL) positivity and levels of vitamin D < 4 µg/l. The case report arises some questions: is vitamin D deficiency due to obesity or APS? Is the positivity of anti-dsDNA indicative of progression to SLE? Is preventive therapy with hydroxychloroquine indicated? Does the high-risk aPL profile justify a high-intensity and life-long anticoagulation regimen?