title: Primary antiphospholipid syndrome presenting with cerebral ischemia, thrombocytopenia, anemia and proteinuria successfully treated with warfarin potassium.
abstract: A 30-year-old woman with primary antiphospholipid syndrome (PAPS) presented with cerebral ischemia, thrombocytopenia, anemia and proteinuria. Administration of warfarin potassium, without concomitant corticosteroid administration, significantly improved all of these symptoms along with a decrease in the titers of antiCL-beta2-GP-I antibodies and a shortening of prolonged APTT. Therefore, the antiphospholipid antibodies in this patient could have been evoked by vitamin-K-dependent coagulation factors or plasma proteins which are assumed to undergo conformational changes exposing cryptic epitopes. This case report provides clues to the mechanisms underlying the production of antiphospholipid antibodies in patients with PAPS.
authors.affiliation: Department of Internal Medicine II, Fukushima Medical University School of Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Miyata
authors.forename: Y
authors.initials: Y
authors.lastname: Sakata
authors.forename: G
authors.initials: G
authors.lastname: Shibukawa
authors.forename: H
authors.initials: H
authors.lastname: Shishido
authors.forename: O
authors.initials: O
authors.lastname: Munakata
authors.forename: Y
authors.initials: Y
authors.lastname: Kazuta
authors.forename: K
authors.initials: K
authors.lastname: Shio
authors.forename: T
authors.initials: T
authors.lastname: Sasajima
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: R
authors.initials: R
authors.lastname: Kasukawa
mesh_terms: D000328:Adult; D000740:Anemia / Q000175:diagnosis / Q000188:drug therapy*; D000925:Anticoagulants / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy*; D002308:Cardiolipins / Q000097:blood; D005260:Female; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D010314:Partial Thromboplastin Time; D011507:Proteinuria / Q000175:diagnosis / Q000188:drug therapy*; D013921:Thrombocytopenia / Q000175:diagnosis / Q000188:drug therapy*; D014859:Warfarin / Q000627:therapeutic use*; D053482:beta 2-Glycoprotein I
chemical_list: D000925:Anticoagulants; D002308:Cardiolipins; D006023:Glycoproteins; D053482:beta 2-Glycoprotein I; D014859:Warfarin