Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2021

Open Access 01-12-2021 | Antiphospholipid Syndrome | Case report

Coronavirus-disease-2019-induced antiphospholipid-like syndrome: a case report

Authors: Fatemeh Bahramnezhad, Banafsheh Ghorbani, Meysam Ghaedrahamt, Hamidreza Jamaati

Published in: Journal of Medical Case Reports | Issue 1/2021

Login to get access

Abstract

Background

This paper describes a case of antiphospholipid syndrome-like condition caused by coronavirus disease 2019. The medical community still faces many diagnostic and therapeutic challenges vis-à-vis coronavirus disease 2019. Ultimately, coronavirus disease 2019 is diagnosed on the basis of laboratory and radiological findings. Considering the high rate of mortality due to coagulation abnormalities and thrombosis among coronavirus disease 2019 patients, it is important to pay attention to the differential diagnoses of coronavirus disease 2019 and other diseases following thrombotic events.

Case description

The patient was a 56-year-old Iranian man who underwent coronary artery bypass graft surgery and mitral valve repair. During hospitalization, the patient showed an elevated level of anticardiolipin antibody (immunoglobulin G isotype), antiphospholipid antibodies, and thrombosis in the brachial artery of the left hand, based on which a differential diagnosis of antiphospholipid syndrome was made. However, ultimately, the coronavirus disease 2019 polymerase chain reaction test and computed tomography scan of the lungs showed that the patient had coronavirus disease 2019.

Conclusion

According to the few studies performed on coronavirus disease 2019 patients, elevated levels of the isotypes of antiphospholipid antibodies in coronavirus disease 2019 patients create conditions similar to antiphospholipid syndrome, which, in the absence of reliable coronavirus disease 2019 testing, can lead to misdiagnosis and consequently delayed or improper treatment. Therefore, to provide timely and appropriate treatment, it is important to pay attention to differential diagnosis.
Literature
1.
go back to reference Jamaati H, Fadaizadeh L, Khoundabi B, Hashemian SM, Monjazabi F, Jahangirifard A, et al. COVID-19-related severe heterogeneous acute respiratory distress syndrome: a therapeutic challenge. Biomed Biotechnol Res J (BBRJ). 2020;4(5):75. Jamaati H, Fadaizadeh L, Khoundabi B, Hashemian SM, Monjazabi F, Jahangirifard A, et al. COVID-19-related severe heterogeneous acute respiratory distress syndrome: a therapeutic challenge. Biomed Biotechnol Res J (BBRJ). 2020;4(5):75.
2.
go back to reference Hashemian SMR, Farrokhi R, Tabarsi P, Jamaati H, Velayati AA. Lifesaving combined treatment in a rapidly progressive COVID-19 pneumonia case with extensive lung involvement. Biomed Biotechnol Res J (BBRJ). 2020;4(5):93. Hashemian SMR, Farrokhi R, Tabarsi P, Jamaati H, Velayati AA. Lifesaving combined treatment in a rapidly progressive COVID-19 pneumonia case with extensive lung involvement. Biomed Biotechnol Res J (BBRJ). 2020;4(5):93.
3.
go back to reference Ronco C, Navalesi P, Vincent JL. Coronavirus epidemic: preparing for extracorporeal organ support in intensive care. Lancet Respir Med. 2020;8(3):240–1.CrossRef Ronco C, Navalesi P, Vincent JL. Coronavirus epidemic: preparing for extracorporeal organ support in intensive care. Lancet Respir Med. 2020;8(3):240–1.CrossRef
4.
go back to reference Jamaati H, Dastan F, Tabarsi P, Marjani M, Saffaei A, Hashemian SM. A fourteen-day experience with coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS): an Iranian treatment protocol. Iran J Pharm Res. 2020;19(1):31–6.PubMedPubMedCentral Jamaati H, Dastan F, Tabarsi P, Marjani M, Saffaei A, Hashemian SM. A fourteen-day experience with coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS): an Iranian treatment protocol. Iran J Pharm Res. 2020;19(1):31–6.PubMedPubMedCentral
5.
go back to reference Hung IF-N, Lung K-C, Tso EY-K, Liu R, Chung TW-H, Chu M-Y, et al. Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet. 2020;395(10238):1695–704.CrossRef Hung IF-N, Lung K-C, Tso EY-K, Liu R, Chung TW-H, Chu M-Y, et al. Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet. 2020;395(10238):1695–704.CrossRef
6.
go back to reference Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the treatment of COVID-19—preliminary report. N Engl J Med. 2020. Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the treatment of COVID-19—preliminary report. N Engl J Med. 2020.
7.
go back to reference Lu X, Chen T, Wang Y, Wang J, Yan F. Adjuvant corticosteroid therapy for critically ill patients with COVID-19. Crit Care. 2020;24(1):1–4.CrossRef Lu X, Chen T, Wang Y, Wang J, Yan F. Adjuvant corticosteroid therapy for critically ill patients with COVID-19. Crit Care. 2020;24(1):1–4.CrossRef
8.
go back to reference Xiao SY, Wu Y, Liu H. Evolving status of the 2019 novel coronavirus infection: proposal of conventional serologic assays for disease diagnosis and infection monitoring. J Med Virol. 2020;92(5):464–7.CrossRef Xiao SY, Wu Y, Liu H. Evolving status of the 2019 novel coronavirus infection: proposal of conventional serologic assays for disease diagnosis and infection monitoring. J Med Virol. 2020;92(5):464–7.CrossRef
9.
go back to reference Del Ross T, Ruffatti A, Cuffaro S, Tonello M, Calligaro A, Favaro M, et al. The clinical relevance of the IgM isotype of antiphospholipid antibodies in the vascular antiphospholipid syndrome. Thromb Res. 2015;136(5):883–6.CrossRef Del Ross T, Ruffatti A, Cuffaro S, Tonello M, Calligaro A, Favaro M, et al. The clinical relevance of the IgM isotype of antiphospholipid antibodies in the vascular antiphospholipid syndrome. Thromb Res. 2015;136(5):883–6.CrossRef
10.
go back to reference Kravvariti E, Koutsogianni A, Samoli E, Sfikakis PP, Tektonidou MG. The effect of hydroxychloroquine on thrombosis prevention and antiphospholipid antibody levels in primary antiphospholipid syndrome: a pilot open label randomized prospective study. Autoimmun Rev. 2020:102491. Kravvariti E, Koutsogianni A, Samoli E, Sfikakis PP, Tektonidou MG. The effect of hydroxychloroquine on thrombosis prevention and antiphospholipid antibody levels in primary antiphospholipid syndrome: a pilot open label randomized prospective study. Autoimmun Rev. 2020:102491.
11.
go back to reference Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–7.CrossRef Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–7.CrossRef
12.
go back to reference Levi M, Scully M. How I treat disseminated intravascular coagulation. Blood. 2018;131(8):845–54.CrossRef Levi M, Scully M. How I treat disseminated intravascular coagulation. Blood. 2018;131(8):845–54.CrossRef
14.
go back to reference Garcia D, Erkan D. Diagnosis and management of the antiphospholipid syndrome. N Engl J Med. 2018;378(21):2010–21.CrossRef Garcia D, Erkan D. Diagnosis and management of the antiphospholipid syndrome. N Engl J Med. 2018;378(21):2010–21.CrossRef
15.
go back to reference Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6): e438.CrossRef Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6): e438.CrossRef
16.
go back to reference Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020;63(3):364–74.CrossRef Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020;63(3):364–74.CrossRef
Metadata
Title
Coronavirus-disease-2019-induced antiphospholipid-like syndrome: a case report
Authors
Fatemeh Bahramnezhad
Banafsheh Ghorbani
Meysam Ghaedrahamt
Hamidreza Jamaati
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2021
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-021-02966-4

Other articles of this Issue 1/2021

Journal of Medical Case Reports 1/2021 Go to the issue