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The Challenge of Bleeding in Antiphospholipid Antibody-Positive Patients by Giulia Pazzola; Stéphane Zuily; Doruk Erkan is a Medicine article available to read on EtoBox.

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Antiphospholipid antibody-positive patients can develop bleeding due to capillaritis, microthrombosis, antiprothrombin antibodies, thrombocytopenia, and/or excessive antithrombotic therapy. Clinical characteristics of patients, e.g., renal impairment, elderly, or concomitant medications, are closely related to the risk of bleeding. The management of bleeding in antiphospholipid antibody (aPL)-positive patients is challenging due to the baseline increased risk of thrombosis. If anticoagulation is stopped, it should be restarted as soon as possible once the acute bleeding is controlled; the continuation of anticoagulation despite active bleeding may be required in selected cases. High-dose corticosteroid is the mainstay treatment for diffuse alveolar hemorrhage, lupus anticoagulant-hypoprothrombinemia syndrome, and severe thrombocytopenia; immunosuppressive drugs are also required to improve the long-term outcomes. Hydrocortisone is critical in adrenal hemorrhage patients due to concomitant adrenal insufficiency; despite bleeding, anticoagulation should be maintained as much as possible. Plasma exchange should be considered in catastrophic antiphospholipid syndrome patients with conc

Who reads The Challenge of Bleeding in Antiphospholipid Antibody-Positive Patients?

Author

Giulia Pazzola; Stéphane Zuily; Doruk Erkan

Publisher

Springer Science and Business Media LLC

Published

2015

Language

EN

Field

Medicine (Health Sciences)