A case of antiphospholipid antibody syndrome diagnosed after thrombosis of an arteriovenous shunt.
A 32-year-old male dialysis patient with lupus nephritis was admitted because of shunt obstruction. The arteriovenous fistula was reconstructed, but obstruction recurred twice within several hours after surgery. A high blood level of anticardiolipin beta2-glycoprotein I antibody suggested that shunt obstruction was caused by a thrombotic tendency related to the antiphospholipid antibody syndrome. Accordingly, for the third shunt procedure, antiplatelet therapy (which had been commenced for systemic lupus erythematosus) was combined with dalteparin sodium from before surgery and warfarin was added postoperatively. This regimen prevented shunt obstruction. In conclusion, hemodialysis patients who suffer repeated shunt obstruction should be examined for antiphospholipid antibody syndrome.
Naito
T
T
Ichiyokai Harada Hospital, Japan.
Yorioka
N
N
Kyuden
Y
Y
Yamashita
K
K
Ueda
C
C
Usui
K
K
Shigemoto
K
K
Harada
S
S
Yamakido
M
M
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000209:etiology; D004359:Drug Therapy, Combination; D004868:Equipment Failure; D005500:Follow-Up Studies; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D008181:Lupus Nephritis / Q000150:complications / Q000628:therapy; D008297:Male; D012008:Recurrence; D006435:Renal Dialysis / Q000009:adverse effects; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D014654:Vascular Patency; D014680:Veins / Q000601:surgery
D000925:Anticoagulants