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antiphospholipid syndrome vena cava thrombus

He Meng, Srilakshmi Yalavarthi, Yogendra Kanthi, Levi F Mazza, Megan A Elfline, Catherine E Luke, David J Pinsky, Peter K Henke, Jason S Knight
OBJECTIVE: Antiphospholipid syndrome (APS) is a leading acquired cause of thrombotic events. While antiphospholipid antibodies have been shown to promote thrombosis in mice, the role of neutrophils has not been explicitly studied. Here, we characterized neutrophils in the context of a new model of antiphospholipid antibody-mediated venous thrombosis. METHODS: Mice were administered IgG fractions prepared from patients with APS. At the same time, flow through the inferior vena cava was reduced by a standard stenosis...
October 1, 2016: Arthritis & Rheumatology
Nicholas Marinus Batt, Dean Malik, Miranda Harvie, Hemant Sheth
A 40-year-old woman with antiphospholipid syndrome presented with a 5-day history of right upper quadrant (RUQ) pain, radiating posteriorly, associated with fever and vomiting. She was admitted 1-week prior with an upper respiratory infection and erythema multiforme. Clinical assessment revealed sepsis with RUQ tenderness and positive Murphy's sign. Laboratory results showed raised inflammatory markers, along with renal and liver impairment. CT showed bilateral adrenal infarction and inferior vena cava thrombus...
2016: BMJ Case Reports
Deng-Ho Yang
Antiphospholipid syndrome is a disorder presenting with arterial or venous thrombus and a history of fetal loss. Early diagnosis and adequate treatment is important to prevent multiple organ failures. Here, we described a woman with a two-year history of systemic lupus erythematosus with severe nephrotic syndrome, manifested multiple thrombi over the portal vein and the inferior vena cava, combined with acute renal infarction. The patient underwent splenectomy 10 months ago. Initially, she received anticoagulant treatment and low-dose glucocorticoid, but multiple organ failure progressed...
2012: Case Reports in Immunology
Jeroen J H Bunge, Ubbo S Wiersema, Adriaan Moelker, Jasper van Bommel, Eric T T L Tjwa
Antiphospholipid syndrome is an autoimmune disorder characterized by a hypercoagulable state, leading to arterial and venous thrombosis. We present a 23-year-old patient, suspected of having Budd-Chiari syndrome due to antiphospholipid syndrome, who developed severe and progressive hypoxemia, requiring prolonged mechanical ventilation. After a detailed but unsuccessful workup, a contrast CT scan revealed an occluded superior vena cava and azygos vein-superior vena cava junction and massive right-to-left shunting through a network of systemic to pulmonary venous collaterals...
November 2014: Chest
Ankur Jain
We report a case of a 60-year-old lady who presented with bilateral lower limb swelling and a thyroid swelling with clinical features consistent with thyrotoxicosis. Investigations revealed the presence of a thrombus in bilateral external, internal iliac veins, and inferior vena cava extending up to its infrahepatic part. Hormone profile and radioiodine uptake scan confirmed the diagnosis of Graves' disease. Further workup revealed the presence of antiphospholipid antibodies (confirmed after a repeat test at 12 weeks)...
2014: Clinical Medicine Insights. Case Reports
Dinesh Yadav, Jagdish Chandra, Sunita Sharma, Varinder Singh
Essential thrombocytosis is extremely rare in children. However, when present, it is associated with increased prevalence of antiphospholipid antibodies and thrombo-hemorrhagic complications. The authors report here a child with Budd-Chiari Syndrome resulting from essential thrombocytosis and associated antiphospholipid antibodies. A 13- y-old boy presented with microcytic hypochromic anemia, hepatosplenomegaly and thrombocytosis. CT scan demonstrated calcified thrombus in inferior vena cava (IVC). Diagnosis of essential thrombocytosis was considered in view of persistent thrombocytosis, antiphospholipid antibodies, bone marrow showing increased number, clusters and giant forms of megakaryocytes and IVC thrombosis...
April 2012: Indian Journal of Pediatrics
E Permanyer, J M Alegret, C Muñoz-Guijosa, J M Padró
We present a previously healthy 43-year-old woman with a cardiac mass that caused almost total occlusion of the inferior vena cava at its junction with the right atrium. The resected mass proved to be a thrombus. Preoperative imaging tests could not distinguish it from other intracardiac tumors such as myxoma. A postoperative immunological study revealed a primary antiphospholipid syndrome. This case presents an unusual diagnosis of antiphospholipid syndrome and a rare location of a cardiac thrombus.
April 2011: Thoracic and Cardiovascular Surgeon
A C Spyropoulos
The catastrophic antiphospholipid syndrome is a rare and devastating manifestation of the antiphospholipid syndrome. It is associated with acute multi-organ failure involving three or more end organs in patients with antiphospholipid antibodies. A precipitating event can be found in some cases, and mortality rates have approached 60%. This article describes a case of catastrophic antiphospholipid syndrome in a patient who presented with Budd-Chiari syndrome from membranous obstruction of the inferior vena cava and extensive bone marrow necrosis shortly after a surgical procedure...
October 1999: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Eyal Zifman, Pnina Rotman-Pikielny, Tatiana Berlin, Yair Levy
BACKGROUND: The antiphospholipid syndrome (APS) is a disease with a high prevalence of thromboembolic events, especially pulmonary emboli (PE). These events may recur despite anticoagulation therapy. In such cases, placement of an inferior vena cava (IVC) filter may be considered to prevent propagation of a distal thrombus toward the pulmonary vessels. It is unclear whether the placement of such a filter is beneficial in patients with APS. OBJECTIVE: Retrospective evaluation of the value of IVC filter placement as prophylaxis against recurrent pulmonary emboli in patients with medically treated APS...
June 2009: Seminars in Arthritis and Rheumatism
Joseph Cherian, Elie Gertner
In patients at risk for pulmonary emboli, consideration is often given to placement of an inferior vena cava (IVC) filter to prevent propagation of a distal thrombus. However, long-term benefits remain controversial, and deep venous thrombosis and IVC thrombosis may result from the procedure itself. Whether a filter if beneficial or even detrimental in patients with the antiphospholipid syndrome (APS) is unclear. We reviewed clinical outcomes in 2 patients who had IVC filter placement years before the diagnosis of the APS and 1 who had a contraindication to anticoagulation...
February 2005: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Mio Ebato, Hitomi Kitai, Hideko Kumakura, Yoshiko Nakamura, Nobuyuki Shimizu, Youichi Takeyama
A 62-year-old woman with a history of pulmonary embolism and primary antiphospholipid syndrome (PAPS) with positivity for lupus anticoagulant was admitted to hospital with shortness of breath. A filter had been implanted in her inferior vena cava (IVC) 5 years previously. Emergency echocardiography revealed a lobulated, mobile echogenic mass on the tricuspid valve, and on pulmonary perfusion scintigraphy several apparently new defects were noted. Fibrinolytic therapy improved her symptoms and the pulmonary perfusion, then intravenous heparinization was continued for a further week...
April 2002: Circulation Journal: Official Journal of the Japanese Circulation Society
A Ghirarduzzi, D Galimberti, M Silingardi, G C Cerioli, R Parravicini, C Salvarani, I Iori
Antiphospholipid antibodies are a heterogeneous family of immunoglobulins that includes lupus anticoagulant and anticardiolipin antibodies. They are strongly associated with a clinical syndrome characterized by venous and arterial thrombosis and spontaneous fetal losses. This syndrome may be primary or else secondary to autoimmune or neoplastic diseases. The cardiovascular system is frequently involved with mitral or aortic insufficiency, juvenile myocardial infarction, and primitive pulmonary hypertension...
October 2001: Italian Heart Journal. Supplement: Official Journal of the Italian Federation of Cardiology
A Emre, I Ozden, A Poyanli, O Bilge
We have treated a 33-year-old Budd-Chiari patient (due to antiphospholipid syndrome) with a history of myocardial infarction by placing a vascular stent in the inferior vena cava and performing a portorenal shunt with three objectives: (1) to perform a shunt operation on a Budd-Chiari patient with good hepatic functional reserve, (2) to avoid a thoracotomy and manipulation of the heart in a patient with a cardiac thrombus and a history of myocardial infarction and (3) to avoid a synthetic graft in a patient with antiphospholipid syndrome...
2001: Digestive Surgery
J E Wildberger, T Schmitz-Rode, T Reffelmann, E Siewert, D Hübner, R W Günther
PURPOSE: To evaluate the feasibility of percutaneous thrombectomy for the removal of floating iliocaval thrombi using a balloon sheath. MATERIALS AND METHODS: A newly developed balloon sheath (inner diameter: 12-F; outer diameter: 18-F) was tested in two patients with extensive iliocaval thrombosis. Mechanical thrombectomy was performed due to recurrent pulmonary embolism under therapeutic anticoagulation in antiphospholipid-antibody syndrome and, respectively, paraneoplastic thrombosis without a decrease of fresh thrombus mass in spite of pharmacological treatment...
July 2000: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Y Tomer, A Kessler, A Eyal, A Many, Y Shoenfeld
A 55-year-old woman with a lupus like disease, associated with the lupus anticoagulant, was admitted because of facial edema. Her facial swelling was previously attributed to the steroids she had been taking and they were tapered without improvement. Laboratory tests revealed high titers of anticardiolipin antibodies. Computerized tomography of her chest and Doppler ultrasound examination of her neck veins demonstrated a thrombus in the superior vena cava. She was treated with heparin and was maintained with longterm warfarin therapy with uneventful followup...
January 1991: Journal of Rheumatology
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