A large and massive abdominal venous thrombosis associated with the presence of a big axillary mass, lupus-like syndrome and antiphospholipid antibodies

• Published in: BMJ case reports 2011-06, Vol.2011 (jun23 1), p.bcr0520114217-bcr0520114217
• Main Authors: Ascer, Elia, Ascer, Liv Goldstein, Gidlund, Magnus
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Antibodies; Antibodies, Antiphospholipid - blood; Anticoagulants; Axilla; Disease; Diverticulitis; Humans; Infections; Ischemia; Lungs; Lupus Erythematosus, Systemic - complications; Lymphadenitis - complications; Lymphatic system; Male; Medical imaging; Reminder of Important Clinical Lesson; South/Central America; Thrombosis; Ulcers; Veins & arteries; Venous Thrombosis - blood; Venous Thrombosis - complications; Venous Thrombosis - diagnosis; White
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr.05.2011.4217

This case report concerns a 40-year-old patient with an unspecific abdominal pain, diarrhoea, a big axillary mass and a previous pulmonary infection. After biopsy of the axillary mass the diagnosis of lymphoma was excluded based on the presence of cells expressing polyclonal antibodies. Abdominal CT scans and angionuclear magnetic resonance showed an extensive intestinal venous thrombosis. The patient also presented positive results for C and S proteins, lupic anticoagulant factor and antiphospholipid antibodies (anticardiolipin antibodies – IgM and IgG). Treatment started with administration of recombinant tissue plasminogen activator and heparin which decreased the degree of thrombosis. Antibiotics were also administrated to treat pulmonary and abdominal infections. After 25 days, he was discharged with no signs of infection, no abdominal pain and reduction of the thrombosis. He was medicated with warfarin, hydroxichloroquine and clopidogrel. Forty-five days after discharge, abdominal CT scan showed a significant regression of thrombosis.