Varón de 62 años con fenómeno de Raynaud
- Conde-Baena, Pablo 1
- Vargas-Hitos, José Antonio 1
- Mario Sabio, José 1
- NavarreteNavarrete, Nuria 1
- Zamora-Pasadas, Mónica 1
- Jiménez-Alonso, Juan 1
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1
Hospital Universitario Virgen de las Nieves
info
ISSN: 0365-7965
Année de publication: 2015
Tomo: 100
Número: 795
Pages: 98-101
Type: Article
D'autres publications dans: Actualidad médica
Résumé
A 62-year-old male presented with a one month history of Raynaud’s phenomenon in both hands along with digital necrotic lesions and severe pain. The medical history and physical examination did not provide any additional information and nailfold capillaroscopy only showed escarce vasculature. Both laboratory (blood count, blood chemistry, thyroid hormones, tumor markers, serologies for hepatitis B and C, proteinogram, immunoglobulins, complement, cryoglobulins, autoimmunity tests) and imaging tests (echocardiography, thoracic and abdominal CT scan and a PET-CT) and even a biopsy of the ischemic lesions were normal or negative. However, the thrombophilia workup showed a heterozygous mutation in the genes of the methylenetetrahydrofolate reductase and the factor XII, and positivity for antiphospholipid antibodies (anti-beta2-glycoprotein). Once the diagnosis of antiphospholipid syndrome and genetic thrombophilia were made, treatment with oral vasodilators (prostacyclin and bosentan) and oral anticoagulants were started, which produced a satisfactory evolution of the ischemic lesions.