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Ítem Hyperferritinemic syndrome: Still’s disease and catastrophic antiphospholipid syndrome triggered by fulminant Chikungunya infection: a case report of two patients(Springer-Verlag London Ltd, 2015-08-02) Echeverry, Alex A.There are four medical conditions characterized by high levels of ferritin, the macrophage activation syndrome (MAS), adult onset Still’ s disease (AOSD), catastrophic antiphospholipid syndrome (CAPS), and septic shock, that share similar clinical and laboratory features, suggesting a common pathogenic mechanism. This common syndrome entity is termed “the hyperferritinemic syndrome.” Here, we describe two different cases of hyperferritinemic syndrome triggered by Chikungunya fever virus infection: a 21-year-old female with SLE and a 32-year-old male patient who developed AOSD after the coinfection of dengue and Chikungunya viruses.Ítem Catastrophic Antiphospholipid Syndrome Triggered by Fulminant Chikungunya Infection in a Patient with Systemic Lupus Erythematosus(John Wiley and Sons Inc., 2016-03-28) Betancur, Juan FelipeThe patient, a 21-year-old woman, was admitted to the intensive care unit with a 4-day history of fever, arthritis of the hands and feet, oli- guria with anasarca, diarrhea, and widespread skin rash. Systemic lupus erythematosus had been diagnosed 5 years previously. She was positive for lupus anticoagulant and anticardiolipin antibody but had no history of thrombotic or obstetric manifestations. Laboratory tests for infection and immunologic or biochemical abnormalities were performed and, based on multiple abnormal findings, treatment with broad-spectrum antibiotics was instituted.Ítem Direct oral anticoagulants in antiphospholipid syndrome: A real life case series(SAGE Publications Ltd, 2016-01-06) Cañas Dávila, Carlos AlbertoAim The aim of this study was to describe a case series of patients with primary or secondary antiphospholipid syndrome (APS) treated with direct oral anticoagulants (DOACs). Patients and methods Clinical charts of eight patients with thrombotic primary or secondary APS treated with direct oral anticoagulants (DOACs) between January 2012 and May 2015 were reviewed. Results The mean age was 45 ± 14.36 (range 27-69 years). Four patients had secondary APS (50%). All patients were initially treated with warfarin by a mean time of 70.87 ± 57.32 months (range 17-153 months). Changes in anticoagulation were defined by recurring thrombosis in five patients (62.5%) and life-threatening bleeding in the other three cases. Seven patients (87.5%) received rivaroxaban treatment and one patient (12.5%) apixaban. The mean follow-up period with DOACs was 19 ± 10.06 months (range 2-36 months). There was no recurrence of thrombosis by the time of data collection. Conclusions Despite not being the standard treatment in APS, we propose DOACs as a rational alternative for the management of patients with this diagnosis. Further interventional clinical studies are necessary for possible standardization of this therapy in APS patients.