Antiphospholipid Syndrome-Induced Leriche Syndrome in a Man with Lower Limbs Sensory and Motor Defect

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disorder with characteristics of arterial and/or venous thrombosis due to hypercoagulation status. Although deep vein thrombosis is common, the involvement of arterial thrombosis is more dangerous and poses a high risk of complications. Acute aorto-iliac occlusive disease (AIOD, known as Leriche syndrome) is severe arterial thrombosis that is associated with high morbidity and mortality rates. Severe acute occlusion may cause spinal cord ischemia, leading to neurological defects, such as acute onset of paraplegia. Co-occurrence of acute aorto-iliac occlusive disease and antiphospholipid syndrome is rare and may present with atypical symptoms mimicking other diseases, including chronic ulcers, musculoskeletal events, and pulmonary diseases. In patients with weak femoral pulses and recurrent thrombotic events, co-occurrence of APS and AIOD should be taken into consideration. Here, we describe a rare case of co-occurrence of APS and AIOD presenting with acute lower leg weakness and numbness. Timely thrombectomies and bilateral common iliac artery stentings rescued distal blood flow. We highlight the clinical features and early diagnosis of co-occurrence of APS and AIOD in order to prevent catastrophic complications. The detailed mechanism and pathogenesis of antiphospholipid syndrome-induced acute aorto-iliac occlusive disease are also discussed.

El Síndrome de Leriche: Subdiagnóstico en la Enfermedad Arterial Periférica

“…La enfermedad oclusiva aorto-ilíaca es una emergencia vascular infrecuente que se relaciona con la ateroesclerosis; aunque, en menor frecuencia, también a estados de hipercoagulabilidad o coagulopatías 5 . La fisiopatología se asienta en la lesión de la pared arterial generando, un daño endotelial y trombosis; es decir, la lesión endotelial ocasionaría una respuesta inflamatoria, la acumulación lipídica y, finalmente, la formación de una placa en la luz vascular 2,6 .…”