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Catastrophic antiphospholipid syndrome and heparin-induced thrombocytopenia-related diseases or chance association?
[heparin-induced thrombocytopenia]
Antiphospholipid
syndrome
(
APS
)
and
heparin-induced
thrombocytopenia
(
HIT
)
are
thrombotic
disorders
due
to
specific
autoimmune
-mediated
antibodies
.
Catastrophic
APS
(
CAPS
)
,
also
known
as
Asherman
's
syndrome
,
is
a
life-threatening
severe
form
of
APS
.
Diagnostic
criteria
for
CAPS
include
the
development
of
a
thrombotic
event
of
three
or
more
organs
in
less
than
a
week
with
the
presence
of
antiphospholipid
antibodies
and
microvascular
thrombosis
on
histology
.
Thrombocytopenia
is
seen
in
more
than
60
%
of
cases
of
CAPS
.
HIT
is
a
life-threatening
disorder
with
the
clinical
presentation
of
thrombocytopenia
and
arterial
or
venous
thrombosis
in
patients
who
develop
antibodies
to
heparin
and
platelet
factor
4
typically
within
10
days
after
starting
heparin
treatment
.
Due
to
the
multiple
similarities
in
clinical
features
and
pathophysiology
of
CAPS
and
HIT
,
it
has
been
postulated
that
these
two
antibody-mediated
disorders
may
be
related
.
We
report
two
cases
in
which
patients
diagnosed
with
CAPS
developed
HIT
very
soon
during
the
same
admission
as
well
as
a
case
of
a
patient
initially
diagnosed
with
HIT
who
presented
with
CAPS
years
later
.
Diseases
Validation
Diseases presenting
"specific autoimmune-mediated antibodies"
symptom
heparin-induced thrombocytopenia
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