Antiphospholipid syndromeas a cause of chestpain and pleural effusion syndrome

Abstract

According to the literature, antiphospholipid syndrome is a rare autoimmune disease that occurs in persons of both sexes. In its course, the syndrome has three types. Each of them has its own peculiarities, but for all of them typically are affection of the vessels of different types (arteries and veins) and diameter. In view of this, signs of angiopathy of different localization manifest the clinical picture. These can be peripheral and central disturbances. Affection of the vessels of the small circle of blood circulation may be accompanied by a clinic of thrombosis, where the main complaints are pain, stinging in to the pleural cavity, and short ness of breath. The «catastrophic» form of the disease ends with multiple organ failure. It is very difficult to bring out patients from this condition. It determines there relevance of the problem.Objective — share with the general medical community the experience of diagnosing and managing such patients.Materials and methods. Under our supervision were two patients who, after 36 weeks of gestation, had signs of a toxic syndrome.Results and discussion. In order to prevent the future development of complications was performed Caesarean section, but it was too late. Concerning the accumulation of pleural effusion, which led to respiratory failure, the pleural puncture was performed, which complicated the bleeding, which, at the background of multipleorgan failure, ending a lethal consequence.Conclusions. Manifestations of vascular in sufficiency should encourage the physician to think about the possibility of antiphospholipid syndrome with subsequent targeted follow-up, including the definition of antibodies to phospholipids. Dispensary observation of such patients should be performed by obstetrician gynecologists in cooperation with adjacent specialists, who may be involved in this syndrome: thoracic phthisiological surgeons, urologists, angiologists. The number of plate cells less than 50 000 ⋅ 109/l should be a contra indication to pleural puncture.