PULMONARY EMBOLISM, THROMBOCYTOPENIA, AND ANTIPHOSPHOLIPID SYNDROME
AbstractThis 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
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
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
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.