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患者女,71岁。6个月前间断出现双下肢紫癜,7d前双小腿出现红斑和坏死,疼痛剧烈,抗心磷脂抗体IgM明显升高,狼疮抗凝物(LAC)和抗β2-糖蛋白I(β2-GPⅠ)均(+),皮损组织病理示:小血管内血栓形成。诊断:抗磷脂抗体综合征。予抗凝治疗3周后患者皮损明显好转。提示临床医师对此类坏死皮损应考虑到本病的可能性,及时予以抗凝治疗。
Female patient, 71 years old. Six months ago, there were intermittent purpura in both lower extremities. Erythema and necrosis of both lower legs appeared before 7 days. Severe pain and IgM of anticardiolipin antibody were significantly increased. LAC and β2- Both (+), lesions showed histopathology: small blood vessels thrombosis. Diagnosis: antiphospholipid antibody syndrome. After anticoagulant therapy for 3 weeks, the skin lesions were significantly improved. Prompt clinicians for such necrotic lesions should take into account the possibility of this disease, timely anticoagulant therapy.