\u00c2ge<\/strong><\/td>\n| 38 ans (n\u00e9e en 1981)<\/td>\n<\/tr>\n | Anamn\u00e8se<\/strong><\/td>\n | \n |
|
Une patiente atteinte du syndrome des anti-phospholipides suit un traitement de fertilit\u00e9 parce qu’elle a d\u00e9j\u00e0 fait deux fausses couches. Dans le cadre d’un examen de laboratoire au d\u00e9but de la grossesse, un syndrome de von Willebrand est \u00e9galement diagnostiqu\u00e9. Cependant, le traitement simultan\u00e9 de ces deux maladies constitue un d\u00e9fi.<\/p>\n
<\/p>\n
Profil de la patiente:<\/strong><\/p>\n VEYVONDI\u00ae<\/sup> sera utilis\u00e9 lorsqu’un traitement seul par desmopressine (DDAVP) est inefficace ou contre-indiqu\u00e9. La posologie et la fr\u00e9quence d\u2019administration doivent \u00eatre adapt\u00e9es \u00e0 chaque patient en fonction de son \u00e9valuation clinique, son poids, du type et de la s\u00e9v\u00e9rit\u00e9 des \u00e9pisodes de saignement \/ de l\u2019intervention chirurgicale et sur le base de la surveillance des param\u00e8tres cliniques et biologiques appropri\u00e9s. Voir \u00e9galement l\u2019information professionnelle actuelle VEYVONDI\u00ae<\/sup> www.swissmedicinfo.ch<\/a><\/span><\/p>\n (Les anticorps anti-phospholipide ont \u00e9t\u00e9 dos\u00e9s \u00e0 plusieurs moments. Seules les valeurs les plus r\u00e9centes sont pr\u00e9sent\u00e9es.)<\/span><\/p>\n <\/span><\/p>\n Une patiente atteinte du syndrome des anti-phospholipides suit un traitement de fertilit\u00e9 parce qu’elle a d\u00e9j\u00e0 fait deux fausses couches. Dans le cadre d’un examen de laboratoire au d\u00e9but de…<\/p>\n","protected":false},"author":12,"featured_media":14206,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Rapport de cas: Grossesse","footnotes":""},"category":[11541,11531,11422,11373,11549],"tags":[54065],"powerkit_post_featured":[],"class_list":["post-14207","post","type-post","status-publish","format-standard","has-post-thumbnail","category-cases-fr","category-formation-continue","category-gynecologie","category-hematologie","category-rx-fr","tag-syndrome-de-willebrand","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-21 11:36:06","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"fr_FR","wpml_translations":{"it_IT":{"locale":"it_IT","id":323047,"slug":"sindrome-di-von-willebrand-e-sindrome-antifosfolipidica","post_title":"Sindrome di Von Willebrand e sindrome antifosfolipidica","href":"https:\/\/medizinonline.com\/it\/sindrome-di-von-willebrand-e-sindrome-antifosfolipidica\/"},"pt_PT":{"locale":"pt_PT","id":323048,"slug":"sindrome-de-von-willebrand-e-sindrome-antifosfolipidica","post_title":"S\u00edndrome de Von Willebrand e s\u00edndrome antifosfolip\u00eddica","href":"https:\/\/medizinonline.com\/pt-pt\/sindrome-de-von-willebrand-e-sindrome-antifosfolipidica\/"},"es_ES":{"locale":"es_ES","id":323049,"slug":"sindrome-de-von-willebrand-y-sindrome-antifosfolipido","post_title":"S\u00edndrome de Von Willebrand y s\u00edndrome antifosfol\u00edpido","href":"https:\/\/medizinonline.com\/es\/sindrome-de-von-willebrand-y-sindrome-antifosfolipido\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/14207","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/comments?post=14207"}],"version-history":[{"count":3,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/14207\/revisions"}],"predecessor-version":[{"id":323234,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/14207\/revisions\/323234"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media\/14206"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media?parent=14207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/category?post=14207"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/tags?post=14207"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/powerkit_post_featured?post=14207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n\n
\n \u00c2ge<\/strong><\/td>\n 38 ans (n\u00e9e en 1981)<\/td>\n<\/tr>\n \n Anamn\u00e8se<\/strong><\/td>\n \n \n
\n Historique g\u00e9n\u00e9tique et familial<\/strong><\/td>\n \n \n
\n Contexte<\/strong><\/td>\n \n \n
\n R\u00e9sultat diagnostique<\/strong><\/td>\n \n \n
\n Traitements et \u00e9volution lors de la grossesse<\/strong><\/td>\n \n \n
\n Suivi<\/strong><\/td>\n \n \n
\n\n
\n Valeurs de laboratoire<\/strong><\/td>\n Valeur normale<\/em><\/strong><\/td>\n Ligne de base<\/strong>
\n(28.01.2020)<\/td>\n8\u00e8me semaine de grossesse <\/strong>(25.02.2020)<\/td>\n 13\u00e8me semaine de grossesse <\/strong>(01.04.2020)<\/td>\n<\/tr>\n \n TCA (aTTP)<\/td>\n 22-29s<\/em><\/td>\n 26s<\/td>\n 25s<\/td>\n 24s<\/td>\n<\/tr>\n \n FVIII:C<\/td>\n 70-200%<\/em><\/td>\n 107%<\/td>\n 111%<\/td>\n 165%<\/td>\n<\/tr>\n \n VWF:Ag<\/td>\n 70-150%<\/em><\/td>\n 45.3%<\/strong><\/td>\n 55.2%<\/strong><\/td>\n 79.6%<\/td>\n<\/tr>\n \n VWF:RCo<\/td>\n 70-150%<\/em><\/td>\n 48.1%<\/strong><\/td>\n 62.6%<\/strong><\/td>\n 98.7%<\/td>\n<\/tr>\n \n VWF:CBA<\/td>\n 50-181%<\/em><\/td>\n 61.9%<\/td>\n 81.2%<\/td>\n 111.1%<\/td>\n<\/tr>\n \n VWF:RCo\/VWF:Ag Ratio<\/td>\n 0.7-1.3<\/em><\/td>\n 1.1<\/td>\n 1.1<\/td>\n 1.2<\/td>\n<\/tr>\n \n Activit\u00e9 de prot\u00e9ine S<\/td>\n 60-120%<\/em><\/td>\n N.I.<\/td>\n 68.0%<\/td>\n 30.8%<\/strong><\/td>\n<\/tr>\n \n Prot\u00e9ine S libre<\/td>\n 60.1-113.6%<\/em><\/td>\n N.I.<\/td>\n 44.3%<\/strong><\/td>\n 50.5%<\/strong><\/td>\n<\/tr>\n \n D-dim\u00e8re<\/td>\n \u22640.5 mg\/L<\/em><\/td>\n N.I.<\/td>\n 0.33 mg\/L<\/td>\n 0.31 mg\/L<\/td>\n<\/tr>\n \n PFA-100<\/td>\n <120s\/<90s<\/em><\/td>\n 300s\/136s<\/strong><\/td>\n N.I.<\/td>\n 167s\/N.I.<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n \n\n
\n Anticorps anti-phospholipide<\/strong><\/td>\n Valeur normale<\/em><\/strong><\/td>\n Valeurs actuelles<\/strong>
\n(28.01.2020)<\/td>\n<\/tr>\n\n \u03b22-Glycoprot\u00e9ine IgM-AC<\/td>\n \u226410 U\/mL<\/em><\/td>\n <2.9 U\/mL<\/td>\n<\/tr>\n \n \u03b22-Glycoprot\u00e9ine IgG-AC<\/td>\n \u226410 U\/mL<\/em><\/td>\n 0.7 U\/mL<\/td>\n<\/tr>\n \n IgA anti-prothrombine<\/td>\n \u226410 U\/mL<\/em><\/td>\n <5.0 U\/mL<\/td>\n<\/tr>\n \n IgM anti-prothrombine<\/td>\n \u226410 U\/mL<\/em><\/td>\n <5.0 U\/mL<\/td>\n<\/tr>\n \n IgG anti-prothrombine<\/td>\n \u226410 U\/mL<\/em><\/td>\n 7.0 U\/mL<\/td>\n<\/tr>\n \n Cardiolipine IgM-AC<\/td>\n \u226410 U\/mL<\/em><\/td>\n 14.0 U\/mL<\/strong><\/td>\n<\/tr>\n \n Cardiolipine IgG-AC<\/td>\n \u226410 U\/mL<\/em><\/td>\n 8.1 U\/mL<\/td>\n<\/tr>\n \n Anticoagulant lupique<\/td>\n 28-34s<\/em><\/td>\n 30.5s<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n \n\n
\n Commentaire du Dr. med. Rosa Sonja Alesci<\/strong><\/p>\n ![\"\"](\"https:\/\/assets.medizinonline.com\/sites\/default\/files\/field\/images\/1drmedrosasonjaalesci_0.png\")
La maladie de von Willebrand et le syndrome anti-phospholipide se produisent souvent ensemble. Dans ce cas, la prise en charge est complexe puisque ces pathologies n\u00e9cessitent des traitements diff\u00e9rents. Le syndrome anti-phospholipide se traite \u00e0 l’aide d\u2019h\u00e9parine et d\u2019aspirine, n\u00e9anmoins l\u2019aspirine doit \u00eatre \u00e9vit\u00e9e lors d’une maladie de von Willebrand. Chez les femmes enceintes, la situation est particuli\u00e8rement difficile puisque le syndrome anti-phospholipide, s’il n’est pas trait\u00e9, peut provoquer des fausses couches et la maladie de von Willebrand des h\u00e9morragies. Dans le cas expos\u00e9, le syndrome anti-phospholipide de la patiente a \u00e9t\u00e9 trait\u00e9 simultan\u00e9ment avec de l’h\u00e9parine et du facteur von Willebrand recombinant (Veyvondi\u00ae<\/sup>) afin de minimiser les h\u00e9morragies. Au vue de la complexit\u00e9 de la situation, des contr\u00f4les fr\u00e9quents ont \u00e9t\u00e9 n\u00e9cessaires afin de pourvoir r\u00e9agir rapidement et ajuster la th\u00e9rapie au besoin. Le traitement de la maladie de von Willebrand de la patiente a pu \u00eatre arr\u00eat\u00e9 apr\u00e8s 6 injections de Veyvondi\u00ae, les valeurs de laboratoire s’\u00e9tant stabilis\u00e9es. A ce jour, le traitement par h\u00e9parine a \u00e9t\u00e9 poursuivi et a \u00e9t\u00e9 compl\u00e9t\u00e9 par l\u2019aspirine afin de g\u00e9rer le syndrome anti-phospholipide.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n![\"\"](\"https:\/\/medizinonline.com\/wp-content\/uploads\/2020\/08\/takeda_logo_rgb.png\"){kind=logo}
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