Catastrophic antiphospholipid syndrome triggered by fulminant disseminated herpes simplex infection in a patient with systemic lupus erythematosus

Lupus. 2012 Oct;21(12):1359-61. doi: 10.1177/0961203312458841. Epub 2012 Aug 28.

Abstract

Infections are considered one of the most common causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE), and occasionally can trigger a catastrophic antiphospholipid syndrome (APS). We describe a 22-year-old SLE patient with lupus nephritis under immunosuppressant therapy and asymptomatic carrier of antiphospholipid antibodies, who was admitted with tonsillitis and acute hepatitis, developing multiorgan failure in a few hours. Postmortem examination revealed hepatic necrosis, tonsillitis, pharyngitis and uterine cervicitis caused by herpes simplex virus (HSV) together with microthrombosis in lungs and glomerular arterioles, suggesting the diagnosis of fulminant HSV disseminated infection and catastrophic APS.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Antiphospholipid / immunology
  • Antiphospholipid Syndrome / etiology
  • Antiphospholipid Syndrome / immunology
  • Antiphospholipid Syndrome / physiopathology*
  • Catastrophic Illness
  • Fatal Outcome
  • Female
  • Herpes Simplex / etiology
  • Herpes Simplex / physiopathology*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Nephritis / complications
  • Lupus Nephritis / drug therapy
  • Multiple Organ Failure / etiology
  • Young Adult

Substances

  • Antibodies, Antiphospholipid
  • Immunosuppressive Agents