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Tormenta Trombiótica: Un Caso Desafiante de Síndrome Antifosfolípido Catastrófico
Ana Filipa Silva1, Mari Mesquita1, Joana Gomes1
1Internal Medicine, Unidade Local de Saúde Tâmega e Sousa, Penafiel, PRT.
Cureus
|January 27, 2026
Resumen
Un paciente con síndrome de Sjögren desarrolló síndrome antifosfolípido catastrófico (CAPS), una afección rara que causa daño multiorgánico generalizado. El diagnóstico y tratamiento tempranos son cruciales para manejar este grave evento trombótico.
Área de la Ciencia:
- Reumatología
- Medicina Interna
- Cuidados Críticos
Sus antecedentes:
- La enfermedad cerebrovascular y el síndrome de Sjögren primario son factores de riesgo conocidos para eventos trombóticos.
- El síndrome antifosfolípido (SAF) es un trastorno autoinmune asociado con coágulos sanguíneos recurrentes.
- El síndrome antifosfolípido catastrófico (CAPS) es una variante potencialmente mortal caracterizada por isquemia orgánica rápida y generalizada.
Objetivo del estudio:
- Presentar un caso clínico de una paciente con sospecha de síndrome antifosfolípido que desarrolló síndrome antifosfolípido catastrófico.
- Destacar los desafíos diagnósticos y la presentación clínica de CAPS en una paciente con comorbilidades autoinmunes.
- Enfatizar la importancia del reconocimiento y manejo tempranos de CAPS.
Principales métodos:
- Informe de caso de una mujer de 68 años con antecedentes de enfermedad cerebrovascular y síndrome de Sjögren primario.
- Observación clínica de diarrea aguda, fiebre y posterior desarrollo de dolor abdominal, defensa, fiebre y vómitos.
- Investigaciones de laboratorio que incluyen marcadores inflamatorios y niveles de creatina quinasa.
- Tomografía computarizada (TC) abdominopélvica para evaluar la isquemia multiorgánica.
Principales resultados:
- Mejora inicial con ciprofloxacina para diarrea aguda y fiebre. Deterioro con signos de peritonitis, marcadores inflamatorios elevados y rabdomiólisis. La tomografía computarizada reveló isquemia multiorgánica, lo que llevó a la sospecha de síndrome antifosfolípido catastrófico (CAPS).
Conclusiones:
- El síndrome antifosfolípido catastrófico (CAPS) puede presentarse de forma aguda en pacientes con afecciones autoinmunes subyacentes como el síndrome de Sjögren.
- La isquemia multiorgánica en imágenes de TC es un hallazgo crítico sugestivo de CAPS.
- El diagnóstico rápido y el manejo agresivo son esenciales para mejorar los resultados en CAPS.
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