title: Isolated type 5 antimitochondrial autoantibodies are associated with a history of thrombocytopenia and fetal loss.
abstract: OBJECTIVE
  To report an unusual case of clinical antiphospholipid syndrome seen with recurrent fetal loss, chronic thrombocytopenia, and recurrent idiopathic thrombocytopenic purpura, in which the only laboratory marker was M5-type antimitochondrial autoantibodies (AMA).
  
  
  METHODS
  Case report.
  
  
  METHODS
  University general hospital, tertiary level of clinical care. Institutional practice.
  
  
  METHODS
  A 65-year-old woman with antiphospholipid syndrome associated with autoimmune polyglandular syndrome of IIIC type.
  
  
  METHODS
  Clinical history and biochemical and immunologic markers.
  
  
  METHODS
  The presence of M5-type AMA in clinical antiphospholipid syndrome isolated by indirect immunofluorescence.
  
  
  RESULTS
  During the 10-year follow-up, immunologic studies detected a persistent positive M5-type AMA at high titer (1/640), antithyroid antibodies, anti-gastric parietal cells, and anti-intrinsic factor. Antinuclear, anti-DNA, and antiphospholipid (anticardiolipin, anti-beta(2)-glycoprotein I) autoantibody tests were all repeatedly negative. Results of coagulation studies and negative lupus anticoagulant were normal on several occasions.
  
  
  CONCLUSIONS
  Our findings suggest the necessity of determining M5-type AMA in the study panel of antiphospholipid syndrome diagnosis, particularly in the absence of other typical autoantibodies.
authors.affiliation: Clinic Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. aoliver@nalcom.com <aoliver@nalcom.com>
authors.forename: Desamparados
authors.initials: D
authors.lastname: Oliver-Miñarro
authors.forename: Silvia
authors.initials: S
authors.lastname: Sanchez-Ramón
authors.forename: Margarita
authors.initials: M
authors.lastname: Rodriguez-Mahou
authors.forename: Silvia
authors.initials: S
authors.lastname: Alvarez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Fernández-Cruz
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology*; D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications*; D001323:Autoantibodies / Q000097:blood*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008928:Mitochondria / Q000276:immunology*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000209:etiology; D012008:Recurrence; D013921:Thrombocytopenia / Q000209:etiology*
chemical_list: D001323:Autoantibodies