Antiphospholipid syndrome with anti-prothrombin autoantibodies in a patient with an axial-flow left ventricular assist device.
Autoantibodies to prothrombin, first described almost 50 years ago, are paradoxically associated with thrombosis. Described is an unusual case of fatal hypercoagulability in a patient with multiple arterial and venous thromboembolic complications despite intense anticoagulation while being bridged to transplantation with a left ventricular assist device. Serum analysis revealed the presence of prothrombin autoantibodies and high titers of anti-nuclear antibodies, and autopsy revealed pulmonary arteriolar vasculitis. These findings suggest an autoimmune basis for the presence of anti-prothrombin antibodies and the hypercoagulable state observed in the present case.
Wadia
Yasmin
Y
Department of Cardiovascular Surgery Research, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, 77225, USA. yasminwadia@yahoo.com
Thiagarajan
Perumal
P
Delgado
Reynolds
R
Allison
Paul
P
Robertson
Kimberly
K
Frazier
O H
OH
D017152:Antibodies, Antiphospholipid / Q000032:analysis; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D001323:Autoantibodies / Q000032:analysis; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000601:surgery*; D018450:Disease Progression; D017809:Fatal Outcome; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D013923:Thromboembolism / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D014850:Waiting Lists
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D001323:Autoantibodies