The autoimmunity conundrum: clotting or inflammation

Antiphospholipid syndrome (APS) is an autoimmune condition with a myriad of clinical manifestations ranging from cardiovascular, neurologic, renal involvement to cutaneous manifestations and thrombocytopenia. We describe a young woman who presented with fever, cough and dyspnea. She had a history of...

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Bibliographic Details
Published in:International journal of rheumatic diseases 2010-10, Vol.13 (4), p.e62-e66
Main Authors: YEE, Dennis Z. Y., TENG, Gim Gee, LIM, Anita Y. N., LOW, Adrian F., VASOO, Sheila
Format: Article
Language:English
Subjects:
Abortion, Habitual - etiology
Acute Disease
Adult
antiphospholipid syndrome
Antiphospholipid Syndrome - blood
Antiphospholipid Syndrome - complications
Antiphospholipid Syndrome - diagnosis
Antiphospholipid Syndrome - immunology
Antiphospholipid Syndrome - therapy
Autoimmune diseases
Autoimmunity
Blood Coagulation
Echocardiography, Transesophageal
endocarditis
Endocarditis - blood
Endocarditis - etiology
Endocarditis - immunology
Endocarditis - therapy
Female
Heart Failure - blood
Heart Failure - etiology
Heart Failure - immunology
Heart Failure - therapy
Humans
Inflammation Mediators - metabolism
Lupus
Lupus Erythematosus, Systemic - blood
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - diagnosis
Lupus Erythematosus, Systemic - immunology
Lupus Erythematosus, Systemic - therapy
Medical treatment
Radiography, Thoracic
systemic lupus erythematosus
Treatment Outcome
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Description
Summary:Antiphospholipid syndrome (APS) is an autoimmune condition with a myriad of clinical manifestations ranging from cardiovascular, neurologic, renal involvement to cutaneous manifestations and thrombocytopenia. We describe a young woman who presented with fever, cough and dyspnea. She had a history of recurrent pregnancy losses and her antiphospholipid antibodies and lupus serologies were positive. Echocardiography showed mobile mitral and aortic valve vegetations. She was treated as for infective endocarditis and diagnosed with primary APS with lupus‐like disease. Vigilance is required to establish if there is an underlying rheumatological condition in a patient who presents with presumptive infective endocarditis in the absence of risk factors. Treatment for systemic lupus erythematosus and primary APS are distinct.
ISSN:1756-1841
1756-185X
DOI:10.1111/j.1756-185X.2010.01534.x