临床病例讨论第460例——下肢肿痛，粪潜血阳性  

The 460th case： lower extremity edema, positive fecal occult blood

作　　者：孙伊多 赵久良[1] 张瀑 王迁[1] 李梦涛[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院风湿免疫科,100730

出　　处：《中华内科杂志》2017年第12期974-976,共3页Chinese Journal of Internal Medicine

摘　　要：患者女性，61岁，因左下肢肿痛、粪潜血阳性先后两次就诊于北京协和医院风湿免疫科，既往2次不良妊娠史，实验室检查抗心磷脂抗体持续阳性，下肢深静脉超声检查证实深静脉血栓形成，诊断抗磷脂综合征，予低分子肝素序贯华法林抗凝治疗。患者随诊发现持续粪潜血阳性，无腹痛、黑便、消瘦等症状，遂行结肠镜筛查证实直肠肿瘤，手术切除后症状好转，抗磷脂抗体转阴。提示部分恶性肿瘤患者可继发抗磷脂综合征，高龄患者易合并，因此对老年发病的抗磷脂综合征患者，需警惕潜在恶性疾病可能，应积极筛查肿瘤。An 61-year-old woman presenting deep vein thrombosis and persistent positive anticardiolipin antibodies was diagnosed as antiphospholipid syndrome and treated with low molecular weight heparin. Before and after anticoagulant therapy, continuous positive fecal occult-blood was found asymptomatically. Colonoscopy confirmed rectal cancer. Antiphospholipid autoantibodies are non-specially positive in some malignances, especially in elder onset patients. Thus, routine screening of malignancies is strongly suggested.

关 键 词：抗磷脂综合征 抗体 抗磷脂 肿瘤 

分 类 号：R739.96[医药卫生—肿瘤]