Katastrofik antifosfolipid sendromu nadir görülen hızlı seyirli mortalitesi yüksek antifosfolipid antikor sendromunun ciddi bir formudur. Sendrom, yaygın mikro trombozlara bağlı olarak multiorgan yetmezliğine neden olur. Bu olguda 58 yaşında kadın hasta da alt extremite distal bölgeden başlayan ekimozlar üst bacak bölgesine ve üst extremiteye yayılan lezyonlar hızlı seyir göstererek nekrotik alanlara dönüştü. Histopatolojik incelemede dermiste intravasküler trombüsler tespit edilen hastanın laboratuvar bulgularında IgM anti-kardiyolipin antikor ve Lupus antikoagülan’ı pozitifti. Klinik seyir çok hızlı ilerleyen hastada akciğer ve böbrek tutulumu da eşlik etti. Mevcut bulgularla hastaya katastrofik antifosfolipid sendromu tanısı konuldu. Katastrofik antifosfolipid sendromu vakalarının üçte ikisin de, en sık enfeksiyonların tetiklemesine sekonder olarak gelişmektedir. Katastrofik antifosfolipid sendromu’na otoimmün hastalıklar özellikle sistemik lupus eritematozus eşlik etmektedir. Olgumuz Sjögren sendromunun katastrofik APS etyolojisinde düşünülmesini gerektiğini vurgulamak amacıyla sunulmaktadır.
Purpose: The aim of this study is to adapt the Cleveland Adölesan Sleep Survey to Turkish and to evaluate its suitability for high school students. Tools and Methods: Planned study in a Cutting-edge type was carried out with 329 students in a high school. The data was collected between January-February 2019 using the data collection form, Epworth Sleep Scale and Cleveland Adolescent Sleep Survey. Results: The verifying factor analysis confirmed the four-dimensional original structure that the scale possesses. The measurement’s model adjustment index; Ki-quare value (χ2=172,78, df=96, p=0,000), the estimated root error square average=0,049, comparative adjustment index=0,98, measurated adjustment good =0,96, unmeasurated adjustment good =0,98, adjustment index=0,94, corrected adjustment good =0,91, showed the perfect adjustment level with the values. The factor loads of the measurement matter vary between 0.58 and 1.13, and the t values were significantly determined. The scale provided a high level of reliability with a reliable ratio of 0.87. It was also a similar measurement tool that measured sleepiness by determining the average positive and meaningful relationship (0,638) between the Epworth Sleepiness Scale and the Cleveland Adolescent Sleepiness Survey. The adjustment study found that the Cleveland Adoleshent Sleep Survey was a suitable and reliable measurement tool for high school students to determine their sleep status.
Catastrophic antiphospholipid syndrome is a rare but rapidly progressing form of antiphospholipid antibody syndrome with high mortality. The syndrome causes multiorgan failure associated with diffuse micro-thromboses. Necrotic-appearing ecchymotic lesions emerging from the distal aspect of both lower extremities and progressing to the upper leg region, and to the upper extremities developed in a 58-year-old woman. Histopathological examination of the biopsy specimen revealed intravascular microthrombi in the dermis. Laboratory findings for anti-cardiolipin antibodies IgM and lupus anticoagulant resulted positive. Lung and kidney involvement was observed. The clinical course progressed very quickly, and catastrophic antiphospholipid syndrome was diagnosed with these findings. Two-thirds of catastrophic antiphospholipid syndrome cases develop due to secondary causes, the most common being infections. Catastrophic antiphospholipid syndrome may also accompany autoimmune diseases, particularly systemic lupus erythematosus. This report is presented to emphasize that Sjögren's syndrome should be considered in the etiology of catastrophic antiphospholipid syndrome.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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