Pulmonary Thrombosis with Transient Antiphospholipid Syndrome after Mononucleosis-like Illness

Tanizawa, Kiminobu; Nakatsuka, Daisuke; Tanaka, Eisaku; Inoue, Tetsuro; Sakuramoto, Minoru; Minakuchi, Masayoshi; Hashimoto, Seishu; Noma, Satoshi; Azuma, Teruhisa; Ishimaru, Hiroyasu; Hatta, Kazuhiro; Kohri, Yoshiaki; Terada, Yoshio

doi:10.2169/internalmedicine.48.1949

Cited by 18 publications

(11 citation statements)

References 21 publications

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“…Thromboembolic events develop in a variety of organs in those with APS, 7 but they are rare in cases of a transient elevation of APLA. 4 Only a few cases of a transient elevation of APLA (including transient APS) developed thromboembolic events 2,3,8,9 ; however, SMA is a rare target vessel in cases of a transient elevation of APLA.…”

Section: Discussionmentioning

confidence: 99%

“…1 APS is usually observed in patients with collagen diseases such as systemic lupus erythematosus (SLE). 1 Furthermore, cases of viral infection have been reported to present with a transient elevation of APLA 2,3 ; however, a transient elevation of APLA is not usually associated with clinical thromboembolic events. 4 In this report, we present a case of superior mesenteric artery (SMA) thrombosis associated with a transient elevation of APLA and discuss its pathogenesis and treatment.…”

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confidence: 99%

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A Case of Superior Mesenteric Artery Thrombosis Associated With Transient Elevation of Antiphospholipid Antibodies

Kadono

Inoue²,

Taki

et al. 2015

International Surgery

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Transient elevation of antiphospholipid antibody (APLA) is commonly observed in cases of viral infection; however, it is generally not associated with clinical thromboembolic events. In this report, we present a rare case of superior mesenteric artery (SMA) thrombosis associated with a transient elevation of APLA and discuss its relationship with fibromuscular dysplasia and adenomyosis of the uterus. Furthermore, we discuss the use of anticoagulant therapy in cases with transient elevation of APLA. In this case, a 46-year-old woman with no significant medical history was diagnosed with intestinal stenosis after SMA thrombosis that had been resolved with anticoagulant therapy. Laboratory examination showed elevated levels of anticardiolipin antibody. Resection of the stenosed ileum and hysterectomy for huge adenomyosis were performed. Anticardiolipin antibody level normalized 4 months after the operation. Anticoagulant therapy was withdrawn after anticardiolipin antibody normalized, and the patient has been free from thromboembolic events ever since. Transient elevation of APLA should be kept in mind in all patients with thromboembolic events, including those with no medical history of collagen diseases or infection. In the present case, association with fibromuscular dysplasia and adenomyosis of the uterus is suspected, but further

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A Case of Superior Mesenteric Artery Thrombosis Associated With Transient Elevation of Antiphospholipid Antibodies

Kadono

Inoue²,

Taki

et al. 2015

International Surgery

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“…The most accepted theory argues that thrombosis is initiated due to endothelial damage caused directly by the virus, and accompanied by a transient production of antiphospholipid antibodies; few case reports have been consistent with this theory [Labarca et al, 1997;Vidal et al, 2005;Delbos et al, 2007;Tanizawa et al, 2009]. Other CMV-related pro-thrombotic processes, such as enhanced platelets and leukocytes adhesion to infected endothelium, activation of factor X, and increased circulatory levels of factor VIII, have also been proposed [Squizzato et al, 2005].…”

Section: Discussionmentioning

confidence: 99%

Transient ischemic attack associated with acute cytomegalovirus infection

Amit

Gadoth

Giladi

et al. 2012

Journal of Medical Virology

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Acute cytomegalovirus (CMV) infection is associated with thromboembolism. However, cerebrovascular ischemic events have not been reported in relation to acute CMV infection. A patient with a transient ischemic attack and acute CMV infection is described. Transient appearance of anti-phospholipid antibodies suggests a causal relationship between the two. Physicians should be alert to symptoms and signs of acute CMV infection in patients with idiopathic cerebrovascular ischemic events.

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“…Similar transient elevation has been observed in association with viral infections and thrombosis. [10,11] A diminished protein S activity can occur due to hereditary causes, hepatic damage, pregnancy, oral contraceptive use, estrogen therapy, oral anticoagulation, and treatment with L-asparaginase. The latter four causes do not stand in this case and in the presence of fatty liver and chronic alcoholism, it is likely that some amount of hepatic damage contributed to protein S deficiency.…”

Section: Discussionmentioning

confidence: 99%

Isolated distal cutaneous thrombosis: An unusual presentation and an interesting etiology

Mendiratta¹,

Prakash²,

Jain³

2011

Indian J Dermatol Venereol Leprol

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A middle-aged hypertensive male, with a fatty liver and chronic alcohol intake, relocated to a high altitude of 2100 m above sea level; in the first winter season, he developed bluish skin lesions over the tip of the nose, margins of both ear lobes, both knees, and subungual location. Systemic examination was unremarkable. Skin biopsy showed thrombi in dermal vessels without any evidence of vasculitis; immunofluorescence was negative. Investigations revealed mild elevation in plasma homocysteine levels, weakly positive antinuclear antibodies and elevated antiphospholipid antibodies, methylene tetrahydrofolate reductase C677T heterozygosity, and protein S deficiency. The patient received prednisolone for 2 weeks, aspirin and pentoxyphylline for 3 months, and continues to be on folic acid and vitamin B6. After 3 months, antiphospholipid antibodies and antinuclear antibody levels were normal. Isolated distal cutaneous thrombosis is an uncommon entity and precipitation by extreme cold in a hypertensive male with three thrombophilic states - one transient, one hereditary, and one acquired - is fascinating.

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Pulmonary Thrombosis with Transient Antiphospholipid Syndrome after Mononucleosis-like Illness

Abstract: Antiphospholipid antibodies (aPL)

Cited by 18 publications

References 21 publications

A Case of Superior Mesenteric Artery Thrombosis Associated With Transient Elevation of Antiphospholipid Antibodies

A Case of Superior Mesenteric Artery Thrombosis Associated With Transient Elevation of Antiphospholipid Antibodies

Transient ischemic attack associated with acute cytomegalovirus infection

Isolated distal cutaneous thrombosis: An unusual presentation and an interesting etiology

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