Lúpus eritematoso sistémico – episódio terminal de rápida evolução, com shock e falência multiorgânica

Autores

  • Célia Costa Médica do Internato Complementar de Imuno-alergologia, Serviço de Medicina 3 do Hospital de Santa Maria, Lisboa
  • J. Meneses Santos Consultor de Medicina Interna, Serviço de Medicina 3 do Hospital de Santa Maria, Lisboa
  • C. A. Ferreira Chefe de serviço de Medicina Interna, Serviço de Medicina 3 do Hospital de Santa Maria, Lisboa; Professor Auxiliar da Faculdade de Medicina de Lisboa

Palavras-chave:

lupus eritematoso sistémico, sépsis, síndrome de resposta inflamatória sistémica, falência multiorgânica, leucotrombose

Resumo

Os A.A. apresentam uma doente de 32 anos de idade, com cinco anos de evolução de um lupus
eritematoso sistémico, que, em fase de controlo
aparente da sua doença, falece na sequência
da rápida instalação de um estado de shock e falência multiorgânica.
Admitem que uma exacerbação lúpica ou um
quadro de sepsis, em que o processo inflamatório originou múltiplos fenómenos de leucotrombose, possam ter determinado a evolução clínica observada.

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Referências

Gladman D, Urowitz M. Prognosis, Mortality, and Morbidity in Systemic Lupus Erythematosus. In: Wallace DJ, Hahn BH, eds. Dubois’

Lupus Erythematosus. 6th ed. Philadelphia, USA: Lippincott Williams & Wilkins 2002: 1255-1273.

Trager J, Ward M. Mortality and causes of death in systemic lupus erythematosus. Current Opinion in Rheumatology 2001; 13: 345-351.

Urowitz M, Bookman A, Koehler B et al. The bimodal pattern of systemic lupus erythematosus. Am J Med 1976; 60: 221-225.

Abramson S and Belmont H. SLE Mechanisms of Vascular Injury. Hosp Pract 1998; 15: 107-127.

Belmont H, Abramson S and Lie J. Pathology and pathogenesis of vascular injury in systemic lupus erythematosus. Arthritis Rheum 1996;

: 9-22.

Morrow J, Nelson J, Watts R, Isenberg D. Primary anti-phospholipid antibody syndrome, In: Morrow J, Nelson J, Watts R, Isenberg D, eds.

Autoimmune Rheumatic Disease, 2th ed. Oxford, University Press 1999: 216-232.

Levine J, Branch W and Rauch J. The Antiphospholipid Syndrome. N Engl J Med 2002; 346: 752-763.

Wilson W, Gharavi A, Koike T et al. International consensus statement on preliminary classification criteria for definitive antiphospholipid

syndrome: report of an international workshop. Arthritis Rheum 1999; 42: 1309-1311.

Asherson R. The catastrophic antiphospholipid syndrome, 1998. A review of clinical features, possible pathogenesis and treatment. Lupus

; 7(2): S55-S62.

Wilson W, Gharavi A and Piette J. Internationational classification criteria for antiphospholipid syndrome: synopsis of a post-conference

workshop held at the Ninth International (Tours) aPL Symposium. Lupus 2001; 10: 457-460.

Asherson R, Cervera R, Piette J-C et al. Catastrophic Antiphospholipid Syndrome, Clinical and Laboratory Features of 50 Patientes. Medicine 1998; 77: 195-207.

Riddel S, Shojania M. Disseminated intravascular coagulation in lupus erythematosus responding to prednisone therapy. Am J Hematol

; 23: 65-68.

Musio F, Bohen E, Yuan C, et al. Review of thrombotic thrombocytopenic purpura in the setting of systemic lupus erythematosus. Semin

Arthritis Rheum 1998; 28: 1-19.

Caramaschi P, Riccetti M, Fratta A et al. Systemic lupus erythematosus and thrombotic thrombocytopenic purpura. Report of three cases and review of the literature. Lupus 1998; 7: 37-41.

D’Cruz D. Vasculitis in systemic lupus erythematosus. Lupus 1998; 7: 270-274.

Rangel-Frausto M, Pittet D, Costigan M et al. The natural history of the systemic inflammatory response syndrome (SIRS). A prospective

study. JAMA 1995; 273: 117-123.

Belmont H, Buyon J, Giorno R et al. Up-regulation of endothelial cell adhesion molecules characterizes disease activity in systemic lupus

erythematosus: The Shwartman phenomenon revisited. Arthritis & Rheum 1994; 37: 376-383.

Argenbright L, Barton R. Interactions of leukocyte integrins with intercellular adhesion molecule 1 in the production of inflammatory vascular injury in vivo. J Clin Invest 1992; 89: 259-272.

Riemekasten G, Ziemer S, Haupl T et al. Shwartman phenomenon in a patient with active systemic lupus erythematosus preceding fatal disseminated intravascular coagulation. Lupus 2002; 11: 204-207.

Tamme K, Liigant A, Tapfer H, et al: Bacterial dissemination and the value of blood cultures in patients who die of septic shock. J Int Med

Res 2000; 28(5): 199-206.

Llewelyn M, Cohen J. Diagnosis of infection in sepsis. In: Sprung C, Bernard G, Dellinger R, eds. Guidelines for the Management of Severe Sepsis and Septic Shock. Intensive Care Med 2001; 27: S10-S32.

Bochud P, Glauser M, Calandra T. antibiotics in sepsis. In: Sprung C, Bernard G, Dellinger R, eds. Guidelines for the Management of Severe Sepsis and Septic Shock. Intensive Care Med 2001; 27: S33-S48.

Walport M. Complement (Second of Two Parts). N Engl J Med 2001; 344: 1140-1144.

Strand V. Monoclonal antibodies and other biologic therapies. Lupus 2001; 10: 216-221.

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Publicado

30-06-2003

Como Citar

1.
Costa C, Santos JM, Ferreira CA. Lúpus eritematoso sistémico – episódio terminal de rápida evolução, com shock e falência multiorgânica. RPMI [Internet]. 30 de Junho de 2003 [citado 14 de Julho de 2024];10(2):63-70. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/1798

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