Abdominal thrombotic and ischemic manifestations of the antiphospholipid antibody syndrome: CT findings in 42 patients.
OBJECTIVE
To determine the abdominal computed tomographic (CT) findings in patients with antiphospholipid antibody syndrome (APS).


METHODS
Retrospective review of medical records from two university medical centers from 1994 through 1997 revealed 215 patients who had a hypercoagulable state attributed to primary or secondary APS. Abdominal CT findings in these patients were reviewed for evidence of large-vessel occlusion or visceral ischemia.


RESULTS
In 42 (19.5%) of 215 patients with APS (age range, 32-65 years; mean age, 42 years), abdominal thromboses or ischemic events were detected at CT. Twenty-two (52%) had major vascular thromboses, including those in the inferior vena cava (n = 10), portal and superior mesenteric veins (n = 7), splenic vein (n = 4), and aorta (n = 1). Thirty-six (86%) patients had abdominal visceral ischemia resulting in renal infarction (n = 22), bowel ischemia (n = 13), splenic infarction (n = 6), pancreatitis (n = 3), hepatic infarction (n = 1), and/or hepatic dysfunction with portal hypertension (n = 1). In some patients, more than one abdominal organ and/or vessel was involved.


CONCLUSIONS
Patients who have circulating antiphospholipid antibodies are at risk for major abdominal vascular thromboses and organ infarction. Radiologists must be familiar with this syndrome; they may be the first physicians to suggest the diagnosis on the basis of findings of unusual or recurrent sites of thrombosis, especially in young patients.
Department of Radiology, University of Pittsburgh Medical Center-Presbyterian Hospital, 200 Lothrop St, Room 4660 CHP MT, Pittsburgh, PA 15213-2582, USA.
S
S
Kaushik
M P
MP
Federle
P H
PH
Schur
M
M
Krishnan
S G
SG
Silverman
P R
PR
Ros
D000005:Abdomen / Q000098:blood supply*; D000328:Adult; D000368:Aged; D016736:Antiphospholipid Syndrome / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed