Cyclophosphamide use in a young woman with antiphospholipid antibodies and recurrent cerebrovascular accident.
We have described a 25-year-old woman with recurrent cerebral thrombosis associated with very high levels of antibodies against phospholipids. Antinuclear antibodies and clinical features of a defined connective tissue disease were absent. Treatment with plasmapheresis, prednisone, intravenous cyclophosphamide, and warfarin was accompanied by disappearance from the serum of the lupus anticoagulant and the biologic false-positive test for syphilis; IgG anticardiolipin antibodies persisted, however, and the patient had a second cerebral thrombosis. Clinical improvement ultimately occurred after the dosage of cyclophosphamide was optimized and the level of IgG anticardiolipin antibody decreased to a level lower than any that has been previously associated with thrombotic complications.
Perez
M C
MC
Department of Medicine, Louisiana State University Medical Center, New Orleans 70112.
Wilson
W A
WA
Scopelitis
E
E
D000328:Adult; D000906:Antibodies / Q000032:analysis*; D001779:Blood Coagulation Factors / Q000032:analysis / Q000276:immunology; D002308:Cardiolipins / Q000276:immunology*; D002544:Cerebral Infarction / Q000188:drug therapy / Q000276:immunology*; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D002542:Intracranial Embolism and Thrombosis / Q000188:drug therapy / Q000276:immunology*; D016682:Lupus Coagulation Inhibitor; D010743:Phospholipids / Q000032:analysis; D012008:Recurrence
D000906:Antibodies; D001779:Blood Coagulation Factors; D002308:Cardiolipins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D016682:Lupus Coagulation Inhibitor; D010743:Phospholipids; D003520:Cyclophosphamide