Immunosuppressive treatment in a heart transplantation candidate with antiphospholipid syndrome.
Dilated cardiomyopathy secondary to a devastating anterior myocardial infarction developed in a young patient with the antiphospholipid antibody syndrome. Due to severe left ventricular failure, heart transplantation was considered. To reduce antiphospholipid antibody titer, plasmapheresis followed by immunosuppressive treatment with cyclosporin and azathioprine were attempted in the pretransplant period. The antibody titer normalized after plasmapheresis, but then rose sharply despite immunosuppressive drugs. This case report underscores the failure of cyclosporin, a treatment not previously reported, to control autoimmunity in antiphospholipid syndrome. Moreover, progressive renal insufficiency can develop as a result of the long-term use of this drug.
Dept of Cardiology, Padua University School of Medicine, Italy.
V
V
Pengo
A
A
Biasiolo
P
P
Marson
G
G
De Silvestro
C
C
Agostini
U
U
Livi
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000628:therapy*; D001379:Azathioprine / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000209:etiology; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D016027:Heart Transplantation; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D010956:Plasmapheresis; D011300:Preoperative Care; D017211:Treatment Failure
D016572:Cyclosporine; D001379:Azathioprine