title: [Primary antiphospholipid antibody syndrome with left atrial intracardiac thombosis].
abstract: The present report describes a case of right atrial thrombus in an active 49-year-old man with a primary antiphospholipid syndrome. In 1984, the patient was admitted for autoimmune hemolytic anemia; during the hospitalization it was diagnosed a chronic hepatitis B. In July 1991, the patient had fever, mild jaundice, splenomegaly and pancytopenia; a diagnosis of hairy cell leukemia was made but it was not subsequently confirmed. Interferon therapy was started and the patient's clinical course mildly improved. However, over the same year, he experienced again a clinical deterioration. Lumbar ischemic ulcers occurred. The patient underwent elective splenectomy. Bone marrow biopsy revealed mielodisplastic syndrome. Necrotizing vasculitis with granulomatosis was diagnosed. The patient's condition improved after splenectomy. Repeated laboratory tests showed positivity for antiphospholipid antibodies. Transthoracic and transesophageal echocardiography demonstrated the presence of a right atrial thrombus, confirmed by nuclear magnetic resonance. The patient was started on long-term anticoagulant therapy, that resulted effective in reducing thrombus size.
authors.affiliation: Divisione di Cardiologia, Azienda Ospedaliera A. Cardarelli, Napoli.
authors.forename: S
authors.initials: S
authors.lastname: Amato
authors.forename: G
authors.initials: G
authors.lastname: Gaeta
authors.forename: V
authors.initials: V
authors.lastname: Brancaccio
authors.forename: G
authors.initials: G
authors.lastname: Belfiore
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D001780:Blood Coagulation Tests; D003328:Coronary Thrombosis / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D008875:Middle Aged; D013156:Splenectomy
chemical_list: D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants
vernacular_title: Sindrome da anticorpi antifosfolipidi primaria con trombosi intracardiaca atriale destra.