Pulmonary thrombotic microangiopathic hemolytic anemia treated successfully with anticoagulant monotherapy.
Thrombotic microangiopathic hemolytic anemia (TMHA) caused by antiphospholipid syndrome (APS) is generally associated with renal or neurological complications and plasma exchange is the first line of treatment. We present the case of a 72-year-old woman with APS who had chronic TMHA and pulmonary hypertension without other major complications. TMHA and pulmonary hypertension were refractory to plasma exchange but were treated successfully with anticoagulant monotherapy. Contrast-enhanced computed tomography and perfusion scintigraphy did not detect signs of pulmonary embolism. TMHA localized in pulmonary microvasculature which causes pulmonary hypertension is a very rare complication of APS.
Ishigaki
Kazuyoshi
K
Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. kazuyoshi@mbe.nifty.com
Takizawa
Yasunobu
Y
Maruyama
Junko
J
Setoguchi
Keigo
K
D000368:Aged; D000743:Anemia, Hemolytic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D057049:Thrombotic Microangiopathies / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
D000925:Anticoagulants