PULMONARY EMBOLISM, THROMBOCYTOPENIA, AND ANTIPHOSPHOLIPID SYNDROME

Authors

  • Talha Mahmud

Abstract

This case report describes a young non-smoker male masquerading under the diagnosis of communityacquired pneumonia who was found to have respiratory symptoms attributed to bilateral pulmonaryemboli. There was also evidence of thrombocytopenia and proximal deep venous thrombosis of rightlower limb. He underwent further investigations and was found to have positive anti-cardiolipinantibodies, lupus anticoagulant and prolonged activated partial thromboplastin time due to antiphospholipid antibody syndrome. This article highlights the importance of consideration of earlierdiagnosis in younger patients with congenital thrombophilias that carries potential for prevention andtreatment of life threatening thromboembolic manifestations.Keywords: Anti-phospholipid antibody syndrome, activated partial thromboplastin time, aPTT, deepvenous thrombosis, pulmonary embolism, thrombocytopenia

References

Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey

RL, Cervera R et al. International consensus statement on an

update of the classification criteria for definite antiphospholipid

syndrome (APS). J Thromb Haemost 2006;4:295–306.

Reber G, Tincani A, Sanmarco M, de Moerloose P, Boffa MC.

Proposals for the measurement of anti-beta2-glycoprotein I

antibodies. Standardization group of the European Forum on

Antiphospholipid Antibodies. J Thromb Haemost 2004;2:1860–2.

Galli M, Luciani D, Bertolini G, Barbui T. Lupus anticoagulants

are stronger risk factors for thrombosis than anticardiolipin

antibodies in the antiphospholipid syndrome: a systematic review

of the literature. Blood 2003;101:1827–32.

Dahlback B. Advances in understanding pathogenic mechanisms

of thrombophilic disorders. Blood 2008;112(1):19–27.

Crowther MA, Kelton JG. Congenital thrombophilic states

associated with venous thrombosis: a qualitative overview and

proposed classification system. Ann Intern Med 2003;138:128–34.

Pengo V, Ruffatti A, Legnani C, Gresele P, Barcellona D, Erba N

et al. Clinical course of high-risk patients diagnosed with

antiphospholipid syndrome. J Thromb Haemost 2010;8:237–42.

Bu C, Gao L, Xie W, Zhang J, He Y, Cai G et al. Beta 2-

glycoprotein is a cofactor for tissue plasminogen activatormediated plasminogen activation. Arthritis Rheum

;60(2):559–68.

Bobba RS, Johnson SR, Davis AM. A review of the Sapporo and

revised Sapporo criteria for the classification of antiphospholipid

syndrome. Where do the revised sapporo criteria add value? J

Rheumatol 2007;34:1522–7.

Schmugge M, Revel-Vilk S, Hiraki L, Rand ML, Blanchette VS,

Silverman ED. Thrombocytopenia and thromboembolism in

pediatric systemic lupus erythematosus. J Pediatr 2003;143:666–9.

Mosca M, Tani C, Bombardieri S. Undifferentiated connective

tissue diseases (UCTD): a new frontier for rheumatology. Best

Pract Res Clin Rheumatol 2007;21:1011–23.

Saadoun D, Piette JC, Wahl D, Costedoat-Chalumeau N.

Management of antiphospholipid syndrome. Rev Med Interne.

; 217–22.

Published

2011-12-01