Intracardiac thrombosis in a young female as first presentation of primary antiphospholipid syndrome: A case report

Mediterranean Journal of Rheumatology

ARTICLE

Stylianos T. Panopoulos¹  Maria G. Tektonidou¹ 

[1] First Propaedeutic Department of Internal Medicine, Rheumatologic Unit, Laikon Hospital and Joint Academic Rheumatology Programme of School of Medicine, National and Kapodistrian University of Athens

关键词: primary antiphospholipid syndrome;    cardiac thrombosis;    treatment;   

DOI  :  10.31138/mjr.27.4.194

学科分类：社会科学、人文和艺术（综合）

来源: PCO Convin S.A.

【 摘 要 】

Primary antiphospholipid syndrome (PAPS) is an entity characterized by spontaneous andrecurrentabortion andrecurrentvascular thromboses (arterial and venous). Intracardiacthrombosis is a rare but life-threatening complication of PAPS. Herein we describe a 21 year-old woman admitted to hospital due to left pleurodynia and shortness of breath with no history of thrombotic events. Helix chest tomography scan disclosed pulmonary embolism as well as a filling defect of the inferior vena cava, which in subsequent cardiac magnetic resonance (MRI) proved to be intracardiac thrombus. Laboratory tests showed triple positivity for antiphospholipid antibodies, renal involvement and thrombocytopenia; PAPS, possibly catastrophic, was diagnosed. The patient was treated with iv pulses of corticosteroids, cyclophosphamide, intravenous immunoglobulin and oral anticoagulation (INR levels between 2.5 and 3), improved gradually and was discharged after 15 days of hospitalization. At 6-month follow-up new cardiac MRI revealed complete resolution of the thrombus. Patients with APS that present with pulmonary embolism should be investigated for the possibility of intracardial thrombus. Indefinite anticoagulation treatment in these patients is warranted due to high recurrence rates.

【 授权许可】

CC BY-NC