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Клинический случай ревматоидного артрита с антифосфолипидным синдромом - Научно-практический журнал Cardioсоматика Том 6, №3 (2015)
Клинический случай ревматоидного артрита с антифосфолипидным синдромом
Арабидзе Г.Г., Шапченко А.В., Муслимова О.В. и др. Клинический случай ревматоидного артрита с антифосфолипидным синдромом. КардиоСоматика. 2015; 6 (3): 70–78.
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Аннотация
В статье представлен клинический случай развития вторичного антифосфолипидного синдрома (АФС) на фоне раннего активного ревматоидного полиартрита с осложнением в виде острого тромбоза глубоких вен предплечья слева и хронического тромбоза вен нижней конечности слева. У больного на фоне лечения метотрексатом развилось инфекционное осложнение, что привело к необходимости перейти на терапию лефлуномидом с положительным эффектом. В результате обследования у пациента выявлена достаточно редкая форма феохромоцитомы надпочечника, подтвержденная при компьютерной томографии и исследовании на норметанефрин в плазме крови, не сопровождающаяся повышением артериального давления. В статье приведены современная классификация АФС, патогенез, клинические и лабораторные диагностические критерии, методы терапии как ревматоидного артрита, так и АФС.
Ключевые слова: антифосфолипидный синдром, антифосфолипидные антитела, волчаночный антикоагулянт, антикардиолипиновые антитела, сосудистый тромбоз, антикоагулянты, ревматоидный артрит.
Key words: antiphospholipid syndrome, antiphospholipid antibodies, lupus anticoagulant, anticardiolipin antibodies, vascular thrombosis, anticoagulants, rheumatoid arthritis.
Ключевые слова: антифосфолипидный синдром, антифосфолипидные антитела, волчаночный антикоагулянт, антикардиолипиновые антитела, сосудистый тромбоз, антикоагулянты, ревматоидный артрит.
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Key words: antiphospholipid syndrome, antiphospholipid antibodies, lupus anticoagulant, anticardiolipin antibodies, vascular thrombosis, anticoagulants, rheumatoid arthritis.
Полный текст
Список литературы
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7. Пиманов С.И., Макаренко У.И. Антифосфолипидный синдром. Справ. поликлин. врача. 2007; 8: 4–10. / Pimanov S.I., Makarenko U.I. Antifosfolipidnyi sindrom. Sprav. poliklin. vracha. 2007; 8: 4–10. [in Russian]
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12. Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus anticoagulants: an update. Thromb Haemost 1995; 74: 1185–90.
13. Filipowicz-Sosnowska A, Carwolinska H, Stanislawska-Biernat E et al. Clinical, immunological, morphological and immunofluorescent studies in rheumatoid vasculitis patients. Clin Rheumatol 1994; 13: 372 (Abstr.).
14. Genovese MC. Treatment of rheumatoid arthritis. In G.S.Firestein et al (eds). Kelley’s Textbook of Rheumatology, 8th ed. Philadelphia: Saunders Elsevier, 2009; 2: 1119–43.
15. Gould T et al. Prevalence аnd clinical correlates of anti-phospholipid antibodies in South Africans with systemic lupus erytematosus. Scand J Rheumatol 2006; 35 (1): 29–34.
16. Erkan D, Pierangeli SS. (eds.). Antiphospholipid Syndrome: Insights and Highlights from the 13th International Congress on Antiphospholipid Antibodies. Doi: 10.1007/978-1-4614-3194-7_17. ©Springer Science + Business Media New York 2012.
17. Jeleniewicz R, Majdan M, Targońska-Stępniak B, Dryglewska M. Prevalence of antiphospholipid antibodies in rheumatoid arthritis patients and relationship with disease activity. Pol Arch Med Wewn 2012; 122 (10): 480–6.
18. Khamashta ME et al. Antiphospholipid (Hughes) syndrome. Autoimmunity 2004; 37 (4): 309–12.
19. Levine JS et al. Catastrophic Antiphospholipid syndrome. N Engl J Med 2002; 346 (10): 752–63.
20. Lesley J. Tofacitinib: A Review of its Use in Adult Patients with Rheumatoid Arthritis. Drugs 2013; 73: 857–74.
21. Mehdi A, Uthman I, Khamashna M. Treatment of antiphospholipid syndrome. Int J Clin Rheumatol 2010; 5 (2): 241–54.
22. Miyakis S, Lockshin M, Atsumi T et al. International consensus statement on an update of the classifi cation criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306.
23. Montoya RC, Gajra A. Current status of new anticoagulants in the management of venous thromboembolism. Advances in Hematol 2012. Article ID 856341. Doi: 10,1155/2012/856341.
24. Palomo I, Pinochet C, Alarcón M et al. Prevalence of antiphospholipid antibodies in Chilean patients with rheumatoid arthritis. J Clin Lab Anal 2006; 20 (5): 190–4.
25. Pincus T, Cronstein B, Braun J. Methotrexate – the anchor drug – an introduction. Clin Exp Rheumatol 2010; 28: S1–S2.
26. Radway-Bright EL. Antiphospholipid syndrome, systemic lupus erythematosus and their relatives and spouses. Rhematology (Oxford) 2000; 39 (4): 427–31.
27. Cervera R, Piette J-C, Font J et al. Antiphospholipid Syndrome Clinical and Immunologic Manifestations and Patterns of Disease Expression in a Cohort of 1,000 Patients. Arthr Rheum 2002; 4 (46):1019–27.
28. Ruiz-Irastorza G, Cuadrado M, Ruiz-Arruza I et al. Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th international congress on antiphospholipid antibodies. Lupus 2011; 20: 206–18.
29. Seriolo B, Fasciolo D, Sulli A, Cutolo M. Homocysteine and antiphospholipid antibodies in rheumatoid arthritis patients: relationships with thrombotic events. Clin Exp Rheumatol 2001; 19 (5): 561–4.
30. Smolen JS, Aletaha D, Bijlsma JW et al. T2T Expert Committee. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 2010; 69 (4): 631–7.
31. Smolen JS, Landewe R, Breedveld FC et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 2010. Doi:10.1136/ard.2009.
2. Kalashnikova L.A., Sergeeva E.V., Suvorov A.V. i dr. Diagnostika volchanochnogo antikoagulianta. Metodicheskoe rukovodstvo. M.: Print, 2013. [in Russian]
3. Kondrat'eva L.V., Reshetniak T.M. Antifosfolipidnyi sindrom: diagnostika i profilaktika trombozov. Doktor.Ru. 2010; 3 (54): 52–6. [in Russian]
4. Nasonov E.L., Baranov A.A., Shilkina N.P. i dr. Patologiia sosudov pri antifosfolipidnom sindrome. M.–Iaroslavl'. 1994; s. 29–55. [in Russian]
5. Nasonov E.L., Karateev D.E., Chichasova N.V. Novye rekomendatsii po lecheniiu revmatoidnogo artrita (EULAR, 2013): mesto metotreksata. Nauchno-prakt. revmatologiia. 2013; 51 (6): 8–26. [in Russian]
6. Nikolaev O.V., Men'shikov V.V., Kalinin A.P. i dr. Feokhromotsitoma. M.: Meditsina, 1965; s. 92. [in Russian]
7. Pimanov S.I., Makarenko U.I. Antifosfolipidnyi sindrom. Sprav. poliklin. vracha. 2007; 8: 4–10. [in Russian]
8. Registr lekarstvennykh sredstv Rossii. Doktor: Dermatovenerologiia. 2011; 15: 111–9. [in Russian]
9. Registr lekarstvennykh sredstv Rossii. Doktor: Dermatovenerologiia. 2011; 15: 281–90. [in Russian]
10. Federal'noe rukovodstvo po ispol'zovaniiu lekarstvennykh sredstv. 2014; 15: 429. [in Russian]
11. Federal'noe rukovodstvo po ispol'zovaniiu lekarstvennykh sredstv. 2014; 15: 936. [in Russian]
12. Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus anticoagulants: an update. Thromb Haemost 1995; 74: 1185–90.
13. Filipowicz-Sosnowska A, Carwolinska H, Stanislawska-Biernat E et al. Clinical, immunological, morphological and immunofluorescent studies in rheumatoid vasculitis patients. Clin Rheumatol 1994; 13: 372 (Abstr.).
14. Genovese MC. Treatment of rheumatoid arthritis. In G.S.Firestein et al (eds). Kelley’s Textbook of Rheumatology, 8th ed. Philadelphia: Saunders Elsevier, 2009; 2: 1119–43.
15. Gould T et al. Prevalence аnd clinical correlates of anti-phospholipid antibodies in South Africans with systemic lupus erytematosus. Scand J Rheumatol 2006; 35 (1): 29–34.
16. Erkan D, Pierangeli SS. (eds.). Antiphospholipid Syndrome: Insights and Highlights from the 13th International Congress on Antiphospholipid Antibodies. Doi: 10.1007/978-1-4614-3194-7_17. ©Springer Science + Business Media New York 2012.
17. Jeleniewicz R, Majdan M, Targońska-Stępniak B, Dryglewska M. Prevalence of antiphospholipid antibodies in rheumatoid arthritis patients and relationship with disease activity. Pol Arch Med Wewn 2012; 122 (10): 480–6.
18. Khamashta ME et al. Antiphospholipid (Hughes) syndrome. Autoimmunity 2004; 37 (4): 309–12.
19. Levine JS et al. Catastrophic Antiphospholipid syndrome. N Engl J Med 2002; 346 (10): 752–63.
20. Lesley J. Tofacitinib: A Review of its Use in Adult Patients with Rheumatoid Arthritis. Drugs 2013; 73: 857–74.
21. Mehdi A, Uthman I, Khamashna M. Treatment of antiphospholipid syndrome. Int J Clin Rheumatol 2010; 5 (2): 241–54.
22. Miyakis S, Lockshin M, Atsumi T et al. International consensus statement on an update of the classifi cation criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306.
23. Montoya RC, Gajra A. Current status of new anticoagulants in the management of venous thromboembolism. Advances in Hematol 2012. Article ID 856341. Doi: 10,1155/2012/856341.
24. Palomo I, Pinochet C, Alarcón M et al. Prevalence of antiphospholipid antibodies in Chilean patients with rheumatoid arthritis. J Clin Lab Anal 2006; 20 (5): 190–4.
25. Pincus T, Cronstein B, Braun J. Methotrexate – the anchor drug – an introduction. Clin Exp Rheumatol 2010; 28: S1–S2.
26. Radway-Bright EL. Antiphospholipid syndrome, systemic lupus erythematosus and their relatives and spouses. Rhematology (Oxford) 2000; 39 (4): 427–31.
27. Cervera R, Piette J-C, Font J et al. Antiphospholipid Syndrome Clinical and Immunologic Manifestations and Patterns of Disease Expression in a Cohort of 1,000 Patients. Arthr Rheum 2002; 4 (46):1019–27.
28. Ruiz-Irastorza G, Cuadrado M, Ruiz-Arruza I et al. Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th international congress on antiphospholipid antibodies. Lupus 2011; 20: 206–18.
29. Seriolo B, Fasciolo D, Sulli A, Cutolo M. Homocysteine and antiphospholipid antibodies in rheumatoid arthritis patients: relationships with thrombotic events. Clin Exp Rheumatol 2001; 19 (5): 561–4.
30. Smolen JS, Aletaha D, Bijlsma JW et al. T2T Expert Committee. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 2010; 69 (4): 631–7.
31. Smolen JS, Landewe R, Breedveld FC et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 2010. Doi:10.1136/ard.2009.
2. Калашникова Л.А., Сергеева Е.В., Суворов А.В. и др. Диагностика волчаночного антикоагулянта. Методическое руководство. М.: Принт, 2013. / Kalashnikova L.A., Sergeeva E.V., Suvorov A.V. i dr. Diagnostika volchanochnogo antikoagulianta. Metodicheskoe rukovodstvo. M.: Print, 2013. [in Russian]
3. Кондратьева Л.В., Решетняк Т.М. Антифосфолипидный синдром: диагностика и профилактика тромбозов. Доктор.Ру. 2010; 3 (54): 52–6. / Kondrat'eva L.V., Reshetniak T.M. Antifosfolipidnyi sindrom: diagnostika i profilaktika trombozov. Doktor.Ru. 2010; 3 (54): 52–6. [in Russian]
4. Насонов Е.Л., Баранов А.А., Шилкина Н.П. и др. Патология сосудов при антифосфолипидном синдроме. М.–Ярославль. 1994; с. 29–55. / Nasonov E.L., Baranov A.A., Shilkina N.P. i dr. Patologiia sosudov pri antifosfolipidnom sindrome. M.–Iaroslavl'. 1994; s. 29–55. [in Russian]
5. Насонов Е.Л., Каратеев Д.Е., Чичасова Н.В. Новые рекомендации по лечению ревматоидного артрита (EULAR, 2013): место метотрексата. Научно-практ. ревматология. 2013; 51 (6): 8–26. / Nasonov E.L., Karateev D.E., Chichasova N.V. Novye rekomendatsii po lecheniiu revmatoidnogo artrita (EULAR, 2013): mesto metotreksata. Nauchno-prakt. revmatologiia. 2013; 51 (6): 8–26. [in Russian]
6. Николаев О.В., Меньшиков В.В., Калинин А.П. и др. Феохромоцитома. М.: Медицина, 1965; с. 92. / Nikolaev O.V., Men'shikov V.V., Kalinin A.P. i dr. Feokhromotsitoma. M.: Meditsina, 1965; s. 92. [in Russian]
7. Пиманов С.И., Макаренко У.И. Антифосфолипидный синдром. Справ. поликлин. врача. 2007; 8: 4–10. / Pimanov S.I., Makarenko U.I. Antifosfolipidnyi sindrom. Sprav. poliklin. vracha. 2007; 8: 4–10. [in Russian]
8. Регистр лекарственных средств России. Доктор: Дерматовенерология. 2011; 15: 111–9. / Registr lekarstvennykh sredstv Rossii. Doktor: Dermatovenerologiia. 2011; 15: 111–9. [in Russian]
9. Регистр лекарственных средств России. Доктор: Дерматовенерология. 2011; 15: 281–90. / Registr lekarstvennykh sredstv Rossii. Doktor: Dermatovenerologiia. 2011; 15: 281–90. [in Russian]
10. Федеральное руководство по использованию лекарственных средств. 2014; 15: 429. / Federal'noe rukovodstvo po ispol'zovaniiu lekarstvennykh sredstv. 2014; 15: 429. [in Russian]
11. Федеральное руководство по использованию лекарственных средств. 2014; 15: 936. / Federal'noe rukovodstvo po ispol'zovaniiu lekarstvennykh sredstv. 2014; 15: 936. [in Russian]
12. Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus anticoagulants: an update. Thromb Haemost 1995; 74: 1185–90.
13. Filipowicz-Sosnowska A, Carwolinska H, Stanislawska-Biernat E et al. Clinical, immunological, morphological and immunofluorescent studies in rheumatoid vasculitis patients. Clin Rheumatol 1994; 13: 372 (Abstr.).
14. Genovese MC. Treatment of rheumatoid arthritis. In G.S.Firestein et al (eds). Kelley’s Textbook of Rheumatology, 8th ed. Philadelphia: Saunders Elsevier, 2009; 2: 1119–43.
15. Gould T et al. Prevalence аnd clinical correlates of anti-phospholipid antibodies in South Africans with systemic lupus erytematosus. Scand J Rheumatol 2006; 35 (1): 29–34.
16. Erkan D, Pierangeli SS. (eds.). Antiphospholipid Syndrome: Insights and Highlights from the 13th International Congress on Antiphospholipid Antibodies. Doi: 10.1007/978-1-4614-3194-7_17. ©Springer Science + Business Media New York 2012.
17. Jeleniewicz R, Majdan M, Targońska-Stępniak B, Dryglewska M. Prevalence of antiphospholipid antibodies in rheumatoid arthritis patients and relationship with disease activity. Pol Arch Med Wewn 2012; 122 (10): 480–6.
18. Khamashta ME et al. Antiphospholipid (Hughes) syndrome. Autoimmunity 2004; 37 (4): 309–12.
19. Levine JS et al. Catastrophic Antiphospholipid syndrome. N Engl J Med 2002; 346 (10): 752–63.
20. Lesley J. Tofacitinib: A Review of its Use in Adult Patients with Rheumatoid Arthritis. Drugs 2013; 73: 857–74.
21. Mehdi A, Uthman I, Khamashna M. Treatment of antiphospholipid syndrome. Int J Clin Rheumatol 2010; 5 (2): 241–54.
22. Miyakis S, Lockshin M, Atsumi T et al. International consensus statement on an update of the classifi cation criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306.
23. Montoya RC, Gajra A. Current status of new anticoagulants in the management of venous thromboembolism. Advances in Hematol 2012. Article ID 856341. Doi: 10,1155/2012/856341.
24. Palomo I, Pinochet C, Alarcón M et al. Prevalence of antiphospholipid antibodies in Chilean patients with rheumatoid arthritis. J Clin Lab Anal 2006; 20 (5): 190–4.
25. Pincus T, Cronstein B, Braun J. Methotrexate – the anchor drug – an introduction. Clin Exp Rheumatol 2010; 28: S1–S2.
26. Radway-Bright EL. Antiphospholipid syndrome, systemic lupus erythematosus and their relatives and spouses. Rhematology (Oxford) 2000; 39 (4): 427–31.
27. Cervera R, Piette J-C, Font J et al. Antiphospholipid Syndrome Clinical and Immunologic Manifestations and Patterns of Disease Expression in a Cohort of 1,000 Patients. Arthr Rheum 2002; 4 (46):1019–27.
28. Ruiz-Irastorza G, Cuadrado M, Ruiz-Arruza I et al. Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th international congress on antiphospholipid antibodies. Lupus 2011; 20: 206–18.
29. Seriolo B, Fasciolo D, Sulli A, Cutolo M. Homocysteine and antiphospholipid antibodies in rheumatoid arthritis patients: relationships with thrombotic events. Clin Exp Rheumatol 2001; 19 (5): 561–4.
30. Smolen JS, Aletaha D, Bijlsma JW et al. T2T Expert Committee. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 2010; 69 (4): 631–7.
31. Smolen JS, Landewe R, Breedveld FC et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 2010. Doi:10.1136/ard.2009.
________________________________________________
2. Kalashnikova L.A., Sergeeva E.V., Suvorov A.V. i dr. Diagnostika volchanochnogo antikoagulianta. Metodicheskoe rukovodstvo. M.: Print, 2013. [in Russian]
3. Kondrat'eva L.V., Reshetniak T.M. Antifosfolipidnyi sindrom: diagnostika i profilaktika trombozov. Doktor.Ru. 2010; 3 (54): 52–6. [in Russian]
4. Nasonov E.L., Baranov A.A., Shilkina N.P. i dr. Patologiia sosudov pri antifosfolipidnom sindrome. M.–Iaroslavl'. 1994; s. 29–55. [in Russian]
5. Nasonov E.L., Karateev D.E., Chichasova N.V. Novye rekomendatsii po lecheniiu revmatoidnogo artrita (EULAR, 2013): mesto metotreksata. Nauchno-prakt. revmatologiia. 2013; 51 (6): 8–26. [in Russian]
6. Nikolaev O.V., Men'shikov V.V., Kalinin A.P. i dr. Feokhromotsitoma. M.: Meditsina, 1965; s. 92. [in Russian]
7. Pimanov S.I., Makarenko U.I. Antifosfolipidnyi sindrom. Sprav. poliklin. vracha. 2007; 8: 4–10. [in Russian]
8. Registr lekarstvennykh sredstv Rossii. Doktor: Dermatovenerologiia. 2011; 15: 111–9. [in Russian]
9. Registr lekarstvennykh sredstv Rossii. Doktor: Dermatovenerologiia. 2011; 15: 281–90. [in Russian]
10. Federal'noe rukovodstvo po ispol'zovaniiu lekarstvennykh sredstv. 2014; 15: 429. [in Russian]
11. Federal'noe rukovodstvo po ispol'zovaniiu lekarstvennykh sredstv. 2014; 15: 936. [in Russian]
12. Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus anticoagulants: an update. Thromb Haemost 1995; 74: 1185–90.
13. Filipowicz-Sosnowska A, Carwolinska H, Stanislawska-Biernat E et al. Clinical, immunological, morphological and immunofluorescent studies in rheumatoid vasculitis patients. Clin Rheumatol 1994; 13: 372 (Abstr.).
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Авторы
Г.Г.Арабидзе*1, А.В.Шапченко1, О.В.Муслимова2, О.Ю.Ларина3, А.М.Сороколетов3
1 ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ФГБУ Научный центр экспертизы средств медицинского применения Минздрава России. 127051, Россия, Москва, Петровский б-р, д. 8;
3 ГБУЗ Городская клиническая больница им. С.П.Боткина Департамента здравоохранения г. Москвы. 125284, Россия, Москва, 2-й Боткинский пр-д, д. 5
*arabidze@mail.ru
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 Scientific Center for Expertise of Pharmaceuticals for Medical Use of the Ministry of Health of the Russian Federation. 127051, Russian Federation, Moscow, Petrovskii b-r, d. 8;
3 S.P.Botkin City Clinical Hospital of the Department of Health of Moscow. 125284, Russian Federation, Moscow, 2-i Botkinskii pr-d, d. 5
*arabidze@mail.ru
1 ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ФГБУ Научный центр экспертизы средств медицинского применения Минздрава России. 127051, Россия, Москва, Петровский б-р, д. 8;
3 ГБУЗ Городская клиническая больница им. С.П.Боткина Департамента здравоохранения г. Москвы. 125284, Россия, Москва, 2-й Боткинский пр-д, д. 5
*arabidze@mail.ru
________________________________________________
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 Scientific Center for Expertise of Pharmaceuticals for Medical Use of the Ministry of Health of the Russian Federation. 127051, Russian Federation, Moscow, Petrovskii b-r, d. 8;
3 S.P.Botkin City Clinical Hospital of the Department of Health of Moscow. 125284, Russian Federation, Moscow, 2-i Botkinskii pr-d, d. 5
*arabidze@mail.ru
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