title: Diagnostic and therapeutic problems in two patients with antiphospholipid antibodies, heart valve lesions, and transient ischaemic attacks.
abstract: Two young women (aged 32 and 25 years) with systemic lupus erythematosus and heart valve lesions in association with antiphospholipid antibodies are presented. In addition to the presence of the 'lupus anticoagulant' and false positive Venereal Disease Research Laboratory (VDRL) tests, both patients had high levels of IgG anticardiolipin antibodies. The first patient additionally had contraceptive induced chorea, chorea gravidarum, seven miscarriages, livedo reticularis, pulmonary embolism, and thrombocytopenia and developed culture negative endocarditis as well as hypertension. The second patient, who had presented with hypertension, developed aortic and mitral regurgitation, suspected myocarditis, manifested transient ischaemic attacks, and responded well to anticoagulation and steroid treatment.
authors.affiliation: Lupus Arthritis Research Unit, Rayne Institute, St Thomas's Hospital, London.
authors.forename: R A
authors.initials: RA
authors.lastname: Asherson
authors.forename: D G
authors.initials: DG
authors.lastname: Gibson
authors.forename: D W
authors.initials: DW
authors.lastname: Evans
authors.forename: E
authors.initials: E
authors.lastname: Baguley
authors.forename: G R
authors.initials: GR
authors.lastname: Hughes
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D001779:Blood Coagulation Factors / Q000032:analysis / Q000276:immunology; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D002546:Ischemic Attack, Transient / Q000276:immunology*; D016682:Lupus Coagulation Inhibitor; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D008943:Mitral Valve / Q000473:pathology; D010743:Phospholipids / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D001779:Blood Coagulation Factors; D007074:Immunoglobulin G; D016682:Lupus Coagulation Inhibitor; D010743:Phospholipids