Takayasu Arteritis With Antiphosphatidylserine/Prothrombin Antibody-Positive Antiphospholipid Syndrome

Abstract

A relationship between Takayasu arteritis (TA) and positive antiphospholipid antibody states has been pointed out, but patients with TA complicated with antiphospholipid antibody syndrome (APS) are rare. Here we report the case of a 17-year-old Japanese man diagnosed with TA based on pulselessness of the left brachial artery, discrepancy of blood pressure between the upper extremities, and arterial wall thickening and narrowing of artery in contrast computed tomography. He was also diagnosed with provisional APS based on a pulmonary infarction without narrowing of the pulmonary artery and positive antiphosphatidylserine/prothrombin antibody. The patient also had concurrent Crohn's disease (CD) based on histopathological findings, which may have been associated with TA. We started high-dose corticosteroid therapy and anticoagulation therapy, and his symptoms including fever, dizziness, chest pain, and lower-right uncomfortable abdomen improved.We reviewed 9 cases of TA with APS including our patient by conducting a PubMed search. Based on past reports, we considered the relationship among TA, APS, and CD.Clinicians should bear in mind that many etiologies can exist in 1 patient, and differential diagnoses are essential.

Internal carotid artery occlusion and cerebral infarction in a case of juvenile systemic lupus erythematosus and positive for phosphatidylserine dependent antiprothrombin antibody

“…In patients with Takayasu arteritis, aPL are sometimes found . However, it is difficult to show the radiological evidence of the inflammation of the arterial wall.…”

“…In patients with Takayasu arteritis, aPL are sometimes found. [2][3][4][5] However, it is difficult to show the radiological evidence of the inflammation of the arterial wall. Besides, it is doubtful that aPL are the prime cause of vasculitis, because aPL production might be the result of vasculitis.…”

“…Antiphospholipid antibodies (aPL) are detected in 30-40% of patients with systemic lupus erythematosus (SLE), 1 and can cause major arterial occlusion, suggestive of Takayasu arteritis. [2][3][4][5] Recently, phosphatidylserine-dependent antiprothrombin antibody (aPS/PT), an autoantibody against the prothrombin-phosphatidylserine complex, has been found to be correlated with antiphospholipid syndrome thrombosis. 6 An aPS/PT test offers comparable sensitivity with anticardiolipin antibody, and is a useful confirmatory tool for lupus anticoagulant activity.…”

Reversible Parkinsonism and Multiple Cerebral Infarctions after Pulmonary Endarterectomy in a Patient with Antiphospholipid Syndrome

“…1B ) and no deep vein thrombosis. Although the differential diagnosis between Takayasu's arteritis (TA) and APS is difficult ( 3 ), positron emission tomography (PET) showed no 18 F-fluoro-2-deoxy-D-glucose accumulation in the wall of the artery. We therefore diagnosed him with primary APS without TA.…”

Takayasu Arteritis: A Diagnosis Made Using a Multidisciplinary Approach

“…Takayasu is a giant cell arteritis, which is predominant in young women. Pathology suggests an inflammatory etiology, with a rare incidence of 150 cases annually occurring in Japan or less than three cases per million annually occurring in the United States and Europe [ 1 ]. Diagnosis can be made by computed tomography (CT) angiography, especially when the vascular manifestation predominates the presentation.…”