Multiple Arterial Thrombosis in Seronegative Antiphospholipid Syndrome: Need for New Diagnostic Criteria?

  • Daniele Pastori Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome, Rome, Italy
  • Roberta Misasi Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
  • Maurizio Sorice Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
  • Francesco Cribari Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome, Rome, Italy
  • Danilo Menichelli Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome, Rome, Italy
  • Francesco Violi Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome, Rome, Italy
  • Pasquale Pignatelli Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome, Rome, Italy<

Keywords

Seronegative antiphospholipid syndrome, vimentin, cardiolipin, antibodies, thrombosis

Abstract

Background: Antiphospholipid syndrome (APS) is defined as thromboembolic complications and/or pregnancy morbidity in the presence of persistent increased titres of antiphospholipid antibodies. Nevertheless, some patients with clinical signs suggestive of APS are negative for diagnostic antibodies and may be classified as having seronegative-APS (SN-APS). Among the ‘non-diagnostic’ antibodies, a few studies have suggested that the IgG anti-vimentin/cardiolipin antibodies (AVA/CL) may be associated with risk of thrombosis.
Aims: The aim of this case report is to encourage the assessment of non-conventional antibodies in APS.
Patient and methods: We report the case of a 69-year-old male patient with rapid onset of apparently unexplained multiple exclusively arterial thrombotic events in both coronary and peripheral vascular beds.
Results: The patient did not meet the diagnostic criteria for APS but was positive for AVA/CL, which result persisted on further testing at 3 and 6 months.
Discussion: Ongoing research has revealed the existence of non-criteria antibodies which may be relevant for the diagnosis of SN-APS and should be included in the classification criteria for the disease.

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References

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  • Published: 2019-09-23

    Issue: Vol 6 No 10 (view)

    Section: Articles

    How to cite:
    Pastori, D., Misasi, R., Sorice, M., Cribari, F., Menichelli, D., Violi, F., & Pignatelli, P. (2019). Multiple Arterial Thrombosis in Seronegative Antiphospholipid Syndrome: Need for New Diagnostic Criteria?. European Journal of Case Reports in Internal Medicine, 6(10). https://doi.org/https://doi.org/10.12890/2019_001180