Multiple intrathoracic thrombosis detected on ct scan in patient with antiphospholipid antibody syndrome: case report

Bekti Safarini*  -  Radiology Department, Medical Faculty, Sultan Agung Islamic University Semarang, Indonesia
Dewi Intisari  -  Microbiology Department, Medical Faculty, Sultan Agung Islamic University Semarang, Indonesia

(*) Corresponding Author
DOI: 10.30659/sainsmed.v14i2.1663

Antiphospholipid antibody syndrome (APS) is the clinical correlation between antiphospholipid antibodies and hypercoagulability syndrome. The prevalence of APS in the general population is undetermined. APS disease carries a notable risk of vascular thrombosis. CT scan is the preferred imaging method for assessing thrombosis, although the timing of image acquisition should be considered. The case report detailed the discovery of many intrathoracic thromboses on a CT scan of a patient diagnosed with the uncommon condition APS. Case study: A 34-year-old woman was hospitalized due to dyspnea, cough, and a 3 kg weight loss over a three-month period. She has a background in Deep Vein Thrombosis (DVT). The test results showed abnormalities in protein C, protein S, and high D-dimer levels. The CT scan revealed numerous intrathoracic thrombi. Antiphospholipid syndrome (APS) is an immunological condition that elevates the likelihood of blood clot formation, resulting in thrombosis inside the arteries and veins. The approximate occurrence rate of APS is five occurrences per 100,000 individuals annually. Antiphospholipid syndrome (APS) leads to the formation of blood clots in the legs, a condition referred to as deep vein thrombosis (DVT). This patient had a history of deep vein thrombosis (DVT) and many blood clots within the chest cavity. A CT scan revealed persistent blood clots in the main pulmonary artery and the right and left pulmonary arteries. Antiphospholipid syndrome (APS) can lead to the formation of blood clots in both arteries and veins. CT scan is the preferred method for evaluating thrombosis, and numerous phases are required to examine all blood arteries.

Keywords: Antiphospholipid Antibodi Syndrome; Deep Vein Trombosis

  1. Chao, C., Adam, A., Kim, H., Min Htet, Z., Thawdar Oo, Z., Chen, D., Bachan, M., Khan, Z., & Vukelic, M. (2023). DVT Missed by ultrasound: Confirmed By CT Angiography in antiphospholipid syndrome but delayed. Chest, 164(4): A4068–A4069. https://doi.org/10.1016/j.chest.2023.07.2653
  2. Chaturvedi, S., & R McCrae, K. (2017). Diagnosis and management of the antiphospholipid syndrome. Blood Reviews, 31 (6): 406–417. https://doi.org/10.1016/J.BLRE.2017.07.006
  3. Da Silva, F. F., Levy, R. A., & De Carvalho, J. F. (2014). Cardiovascular Risk factors in the antiphospholipid syndrome. Journal of Immunology Research, 2014: 1–6. https://doi.org/10.1155/2014/621270
  4. Dabit, J. Y., Valenzuela-Almada, M. O., Vallejo-Ramos, S., & Duarte-García, A. (2021). Epidemiology of antiphospholipid syndrome in the general population. Current Rheumatology Reports, 23(85): 1-9. https://doi.org/10.1007/s11926-021-01038-2
  5. Garcia, D., Erkan, D. (2018). Diagnosis and management of the antiphospholipid syndrome. The New England Journal of Medicine, 378 (21): 2010–2021. https://doi.org/10.1056/NEJMra1705454
  6. Dogan, H., De Roos, A., Geleijins, J., Huisman, M., & Kroft, L. (2015). The role of computed tomography in diagnosing acute and chronic pulmonary embolism. Diagnostic and Interventional Radiology, 21(4): 307–316. https://doi.org/10.5152/dir.2015.14403
  7. El-Menyar, A., Nabir, S., Ahmed, N., Asim, M., Jabbour, G., & Al-Thani, H. (2016). Diagnostic implications of computed tomography pulmonary angiography in patients with pulmonary embolism. Annals of Thoracic Medicine, 11 (4): 269–276. https://doi.org/DOI: 10.4103/1817-1737.191868
  8. Gomez-Puerta, J. A., & Cervera, R. (2014). Diagnosis and classification of the antiphospholipid syndrome. Journal of Autoimmunity. http://dx.doi.org/10.1016/j.jaut.2014.01.006
  9. Green, D. (2022). Pathophysiology of Antiphospholipid Syndrome. Thrombosis and Haemostasis, 122(07): 1085–1095. https://doi.org/10.1055/a-1701-2809
  10. Knight, J. S., Branch, D. W., & Ortel, T. L. (2023). Antiphospholipid syndrome: Advances in diagnosis, pathogenesis, and management. BMJ, e069717: 1-20. https://doi.org/10.1136/bmj-2021-069717
  11. Lopes, M. R. U., Danowski, A., Funke, A., Rêgo, J., Levy, R., & Andrade, D. C. O. D. (2017). Update on antiphospholipid antibody syndrome. Revista Da Associação Médica Brasileira, 63(11): 994–999. https://doi.org/10.1590/1806-9282.63.11.994
  12. Matyja-Bednarczyk, A., Swadzba, J., Iwaniec, T., Sanak, M., Dziedzina, S., Cmiel, A., & Musial, J. (2014). Risk factors for arterial thrombosis in an antiphospholipid syndrome. Thrombosis Research, 133: 173–176. http://dx.doi.org/10.1016/j.thromres.2013.22.012
  13. Moore, A. J. E., Wachsmann, J., Chamarthy, M. R., Panjikaran, L., Tanabe, Y., & Rajiah, P. (2018). Imaging of acute pulmonary embolism: An update. Cardiovascular Diagnosis and Therapy, 8(3): 225–243. https://doi.org/10.21037/cdt.2017.12.01
  14. Mora-Ramírez, M., González-Pacheco, H., & Amezcua-Guerra, L. (2016). Stents coated with mammalian target of rapamycin inhibitors (mTOR) appear to be the best choice in patients with antiphospholipid syndrome and myocardial infarction. JCR: Journal of Clinical Rheumatology, 22(5): p.281. https://doi.org/DOI: 10.1097/RHU.0000000000000409
  15. Oliveira, D. C., Correia, A., & Oliveira, C. (2020). The issue of the antiphospholipid antibody syndrome. Journal of Clinical Medicine Research, 12(5): 286–292. https://doi.org/10.14740/jocmr4154
  16. Saponjski, J., Stojanovich, L., Petrovic, J., & Saponsjki, D. (2017). The role of MSCT angiography in early detection of lower limb arterial lesions in patients with antiphospholipid syndrome. Immunologic Research, 65: 482–486. https://doi.org/10.1007/s12026-016-8887-6
  17. Schreiber, K., Sciascia, S., de Groot, P. G., Devreese, K., Jacobsen, S., Ruiz-Irastorza, G., Salmon, J. E., Shoenfeld, Y., Shovman, O., & Hunt, B. J. (2018). Antiphospholipid syndrome. Nature Reviews Disease Primers, 1: 1–20. https://doi.org/10.1038/nrdp.2017.103
  18. Sciascia, S., Sanna, G., Murru, V., Roccatello, D., Khamashta, M. A., & Bertolaccini, M. L. (2015). The global antiphospholipid syndrome score in primary APS. Rheumatology, 54(1): 134–138. https://doi.org/10.1093/rheumatology/keu307
  19. Sugiyama, K., Suzuki, S., Koizumi, N., & Ogino, H. (2020). Antiphospholipid syndrome with chronic thromboembolic pulmonary hypertension and coronary artery disease: A case report. Journal of Cardiothoracic Surgery, 15(225): 1-6. https://doi.org/10.1186/s13019-020-01254-4
  20. Tzouvelekis, A. (2013). CT Findings of pulmonary involvement in antiphospholipid syndrome. British Journal of Medicine and Medical Research, 3(4): 855–867. https://doi.org/10.9734/BJMMR/2013/3007

Open Access Copyright (c) 2023 Bekti Safarini
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Sains Medika: Jurnal Kedokteran dan Kesehatan
is published by Faculty of Medicine Universitas Islam Sultan Agung, Indonesia in association with FOKI (FORUM KEDOKTERAN ISLAM INDONESIA).

Contact: Jl. Raya Kaligawe Km.4, PO BOX 1054/SM Semarang 50112, Indonesia
Phone: +62 8122-9933-369
Website: https://fkunissula.ac.id
Email: sainsmedika@unissula.ac.id

ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

This work is licensed under a Creative Commons Attribution 4.0 International License

Get a feed by atom here, RRS2 here and OAI Links here

apps