Tuberc Respir Dis.  2007 Jul;63(1):72-77. 10.4046/trd.2007.63.1.72.

A Case of Primary Antiphospholipid Syndrome with Pulmonary Thromboembolism

• Lee JB
• Sim YS
• Noh YW
• Park HS
• Tae CH
• Lim SY
• Jun YH
• Ryu YJ
• Chun EM
• Lee JH
• Chang JH
• Moon JW

• KMID: 1877320
• DOI: http://doi.org/10.4046/trd.2007.63.1.72

Abstract

Antiphospholipid syndrome (APS) causes recurrent thromboses and morbidity during pregnancy, including fetal loss. This malady is associated with the persistent presence of anticardiolipin antibody or lupus anticoagulant. The pulmonary manifestations of antiphospholipid syndrome include pulmonary thromboembolism, pulmonary hypertension, acute respiratory distress syndrome, etc. Pulmonary thromboembolism is often the initial manifestation of antiphospholipid syndrome and a timely diagnosis is critical due to the high mortality rate. We herein report on a 19-year-old man with pulmonary thromboembolism that was caused by primary antiphospholipid syndrome. He presented with blood-tinged sputum, fever and epigastric pain, and his chest computerized tomography showed pulmonary thromboembolism. The other possible causes of pulmonary thromboembolism were excluded and the diagnosis of primary antiphospholipid syndrome was confirmed by the lupus anticoagulant that was present on two occasions six weeks apart. We also discuss the nature and management of antiphospholipid syndrome, along with a brief review of the relevant literatures.

Keyword

Antiphospholipid syndrome; Pulmonary thromboembolism; Thrombosis

MeSH Terms

Antibodies, Anticardiolipin
Antiphospholipid Syndrome*
Diagnosis
Fever
Humans
Hypertension, Pulmonary
Lupus Coagulation Inhibitor
Mortality
Pregnancy
Pulmonary Embolism*
Respiratory Distress Syndrome, Adult
Sputum
Thorax
Thrombosis
Young Adult
Antibodies, Anticardiolipin
Lupus Coagulation Inhibitor

Figure

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  Figure 1 Chest PA on admission shows no parenchymal lesion.

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  Figure 2 Chest CT scan on admission shows thrombi in the pulmonary arteries of left lower lobe anteromedial basal segment and right lower lobe posterior basal segment (left) and hemorrhagic infarction with wedge-shaped consolidation in right lower lobe posterior basal segment (right).

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  Figure 3 Lung perfusion scan shows a large wedge-shaped perfusion defect in left lower lobe and another suspicious perfusion defect in right lower lobe.

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  Figure 4 Chest CT scan after 9 months of anticoagulation therapy, shows small residual thrombi in left lower lobe (left) and the resolution of the previous wedge-shaped infarction in right lower lobe (right).

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