title: Right Atrial Thrombosis in Antiphospholipid Syndrome with Secondary Immune Thrombocytopenia.
abstract: Background Antiphospholipid syndrome (APS) is an acquired thrombophilia that can be associated with decreased platelet counts. Case A 67-year-old woman presented with thrombocytopenia and a symptomatic right atrial mass suspicious of cardiac myxoma. Prolongation of the activated partial thromboplastin time (aPTT) was caused by a strong lupus anticoagulant, and bone marrow cytology was consistent with accelerated platelet clearance. The patient underwent uneventful resection of the atrial tumor, which turned out to be a calcified fibrin-rich thrombus. Definitive APS was diagnosed and long-term anticoagulation recommended. Conclusion When evaluating patients with right atrial masses, findings of thrombocytopenia and/or aPTT prolongation should raise the suspicion of APS-associated thrombosis.
authors.affiliation: Universitätsklinikum Hamburg-Eppendorf, II. Medizinische Klinik und Poliklinik, Onkologisches Zentrum, Hamburg, Germany.
authors.forename: Minna
authors.initials: M
authors.lastname: Voigtlaender
authors.affiliation: Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Universitäres Herzzentrum, Hamburg, Germany.
authors.forename: Lenard
authors.initials: L
authors.lastname: Conradi
authors.affiliation: Universitätsklinikum Hamburg-Eppendorf, Institut für Pathologie, Hamburg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Hinsch
authors.affiliation: Universitätsklinikum Hamburg-Eppendorf, II. Medizinische Klinik und Poliklinik, Onkologisches Zentrum, Hamburg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Langer
keywords: antiphospholipid syndrome; immune thrombocytopenia; intracardiac thrombosis; lupus anticoagulant