Partial Splenic Embolization for the Management of Severe Refractory Thrombocytopenia in Antiphospholipid Syndrome: A Case Report and Literature Review
Antiphospholipid syndrome is an autoimmune condition characterized by arteriovenous thromboembolic events. Thrombocytopenia is a common finding among these patients and is typically of mild severity not requiring any treatment. However, severe cases of thrombocytopenia should be treated. Steroids, i...
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Veröffentlicht in: | Vascular and endovascular surgery 2022-04, Vol.56 (3), p.316-320 |
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description | Antiphospholipid syndrome is an autoimmune condition characterized by arteriovenous thromboembolic events. Thrombocytopenia is a common finding among these patients and is typically of mild severity not requiring any treatment. However, severe cases of thrombocytopenia should be treated. Steroids, intravenous immune globulin (IVIG), and immunomodulatory agents are the first-line treatment options, and surgical splenectomy is usually reserved for more severe and refractory cases of thrombocytopenia. Herein, we report the case of a 30-year-old man with primary antiphospholipid syndrome and severe thrombocytopenia. The patient’s thrombocytopenia had been refractory to almost all the medical managements, and surgical splenectomy could not be an option due to the patient’s high-risk condition for surgery. The patient was successfully managed by partial splenic embolization (PSE) which was a unique application of this technique. |
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Thrombocytopenia is a common finding among these patients and is typically of mild severity not requiring any treatment. However, severe cases of thrombocytopenia should be treated. Steroids, intravenous immune globulin (IVIG), and immunomodulatory agents are the first-line treatment options, and surgical splenectomy is usually reserved for more severe and refractory cases of thrombocytopenia. Herein, we report the case of a 30-year-old man with primary antiphospholipid syndrome and severe thrombocytopenia. The patient’s thrombocytopenia had been refractory to almost all the medical managements, and surgical splenectomy could not be an option due to the patient’s high-risk condition for surgery. The patient was successfully managed by partial splenic embolization (PSE) which was a unique application of this technique.</description><identifier>ISSN: 1538-5744</identifier><identifier>EISSN: 1938-9116</identifier><identifier>DOI: 10.1177/15385744211072682</identifier><identifier>PMID: 34978216</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Antiphospholipid Syndrome - complications ; Antiphospholipid Syndrome - diagnosis ; Antiphospholipid Syndrome - therapy ; Embolization, Therapeutic - adverse effects ; Humans ; Male ; Splenectomy - adverse effects ; Thrombocytopenia - complications ; Thrombocytopenia - therapy ; Treatment Outcome</subject><ispartof>Vascular and endovascular surgery, 2022-04, Vol.56 (3), p.316-320</ispartof><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-4021ca3fbb8ccd728c6521ba6ebb60c233f8c49ba492acd0102fc79633eb78e83</citedby><cites>FETCH-LOGICAL-c340t-4021ca3fbb8ccd728c6521ba6ebb60c233f8c49ba492acd0102fc79633eb78e83</cites><orcidid>0000-0002-1404-910X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/15385744211072682$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/15385744211072682$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34978216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jalili, Javad</creatorcontrib><creatorcontrib>Pourghorban, Ramin</creatorcontrib><creatorcontrib>Mahmoudpour, Masoud</creatorcontrib><creatorcontrib>Akhavi Milani, Ali</creatorcontrib><title>Partial Splenic Embolization for the Management of Severe Refractory Thrombocytopenia in Antiphospholipid Syndrome: A Case Report and Literature Review</title><title>Vascular and endovascular surgery</title><addtitle>Vasc Endovascular Surg</addtitle><description>Antiphospholipid syndrome is an autoimmune condition characterized by arteriovenous thromboembolic events. Thrombocytopenia is a common finding among these patients and is typically of mild severity not requiring any treatment. However, severe cases of thrombocytopenia should be treated. Steroids, intravenous immune globulin (IVIG), and immunomodulatory agents are the first-line treatment options, and surgical splenectomy is usually reserved for more severe and refractory cases of thrombocytopenia. Herein, we report the case of a 30-year-old man with primary antiphospholipid syndrome and severe thrombocytopenia. The patient’s thrombocytopenia had been refractory to almost all the medical managements, and surgical splenectomy could not be an option due to the patient’s high-risk condition for surgery. The patient was successfully managed by partial splenic embolization (PSE) which was a unique application of this technique.</description><subject>Adult</subject><subject>Antiphospholipid Syndrome - complications</subject><subject>Antiphospholipid Syndrome - diagnosis</subject><subject>Antiphospholipid Syndrome - therapy</subject><subject>Embolization, Therapeutic - adverse effects</subject><subject>Humans</subject><subject>Male</subject><subject>Splenectomy - adverse effects</subject><subject>Thrombocytopenia - complications</subject><subject>Thrombocytopenia - therapy</subject><subject>Treatment Outcome</subject><issn>1538-5744</issn><issn>1938-9116</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc2OFCEURonROD_6AG4MSzc1cqGaotx1OqNj0kZjj-sKULdsJlVQAjWmfRFfV9oe3Zi4IJfknu8k8BHyAtgVQNO8hpVQq6auOQBruFT8ETmHVqiqBZCPy73sqyNwRi5SumMMFNTqKTkTddsoDvKc_PykY3Z6pLt5RO8svZ5MGN0PnV3wdAiR5j3SD9rrrzihzzQMdIf3GJF-xiFqm0M80Nt9DCVnDznMxaKp83Tts5v3IZUzutn1dHfwfcHwDV3TjU5HwRxiptr3dOsyRp2X39p7h9-fkSeDHhM-f5iX5Mvb69vNTbX9-O79Zr2trKhZrmrGwWoxGKOs7RuurFxxMFqiMZJZLsSgbN0aXbdc254B44NtWikEmkahEpfk1ck7x_BtwZS7ySWL46g9hiV1XILkSrYSCgon1MaQUsShm6ObdDx0wLpjH90_fZTMywf9Yibs_yb-FFCAqxOQygd3d2GJvjz3P8Zf_02VzQ</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Jalili, Javad</creator><creator>Pourghorban, Ramin</creator><creator>Mahmoudpour, Masoud</creator><creator>Akhavi Milani, Ali</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1404-910X</orcidid></search><sort><creationdate>20220401</creationdate><title>Partial Splenic Embolization for the Management of Severe Refractory Thrombocytopenia in Antiphospholipid Syndrome: A Case Report and Literature Review</title><author>Jalili, Javad ; Pourghorban, Ramin ; Mahmoudpour, Masoud ; Akhavi Milani, Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-4021ca3fbb8ccd728c6521ba6ebb60c233f8c49ba492acd0102fc79633eb78e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Antiphospholipid Syndrome - complications</topic><topic>Antiphospholipid Syndrome - diagnosis</topic><topic>Antiphospholipid Syndrome - therapy</topic><topic>Embolization, Therapeutic - adverse effects</topic><topic>Humans</topic><topic>Male</topic><topic>Splenectomy - adverse effects</topic><topic>Thrombocytopenia - complications</topic><topic>Thrombocytopenia - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jalili, Javad</creatorcontrib><creatorcontrib>Pourghorban, Ramin</creatorcontrib><creatorcontrib>Mahmoudpour, Masoud</creatorcontrib><creatorcontrib>Akhavi Milani, Ali</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Vascular and endovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jalili, Javad</au><au>Pourghorban, Ramin</au><au>Mahmoudpour, Masoud</au><au>Akhavi Milani, Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Partial Splenic Embolization for the Management of Severe Refractory Thrombocytopenia in Antiphospholipid Syndrome: A Case Report and Literature Review</atitle><jtitle>Vascular and endovascular surgery</jtitle><addtitle>Vasc Endovascular Surg</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>56</volume><issue>3</issue><spage>316</spage><epage>320</epage><pages>316-320</pages><issn>1538-5744</issn><eissn>1938-9116</eissn><abstract>Antiphospholipid syndrome is an autoimmune condition characterized by arteriovenous thromboembolic events. 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subjects | Adult Antiphospholipid Syndrome - complications Antiphospholipid Syndrome - diagnosis Antiphospholipid Syndrome - therapy Embolization, Therapeutic - adverse effects Humans Male Splenectomy - adverse effects Thrombocytopenia - complications Thrombocytopenia - therapy Treatment Outcome |
title | Partial Splenic Embolization for the Management of Severe Refractory Thrombocytopenia in Antiphospholipid Syndrome: A Case Report and Literature Review |
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