Two Faces of the Same Coin: A Case Report of Antiphospholipid Syndrome Nephropathy

  • Sofia Homem de Melo Marques Department of Nephrology, Centro Hospitalar São João, Porto
  • Hugo André Nascimiento Ferreira Department of Nephrology, Centro Hospitalar São João, Porto
  • Ana Teresa Pires de Morais Nunes Department of Nephrology, Centro Hospitalar São João, Porto
  • Roberto Nicolau Pestana Silva Department of Anatomic Pathology, Centro Hospitalar São João, Porto
  • Susana Maria Moreira Sampaio Norton Department of Nephrology, Centro Hospitalar São João, Porto
Keywords: Antiphospholipid syndrome, Antiphospholipid syndrome nephropathy, kidney biopsy, thrombotic microangiopathy

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease which can be primary or secondary to other autoimmune conditions and is defined by the occurrence of arterial or venous thrombosis, or pregnancy morbidity associated with persistently positive antiphospholipid antibodies (aPLA). The kidney may be affected by thrombosis at any level of its vasculature. When small vessels are involved, this results in thrombotic microangiopathy (TMA), which can manifest as either acute vaso-occlusive or chronic vascular lesions in glomeruli, arterioles and interlobular arteries. We report the case of 26-year-old man, with a previous medical history suggestive of APS, who was found to have a small elevation in serum creatinine. A kidney biopsy was performed and revealed features of chronic TMA. Anticoagulation was begun and kidney function remained stable. However, one year later, upon suspension of anticoagulation, the patient developed acute kidney injury and a second kidney biopsy showed acute TMA. This case describes different manifestations of antiphospholipid syndrome nephropathy (APSN) and highlights the importance of anticoagulation for thrombosis prevention.

Author Biography

Sofia Homem de Melo Marques, Department of Nephrology, Centro Hospitalar São João, Porto
Nephrology

References

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  • Published: 2017-04-27

    Issue: Vol 4 No 3 (view)

    Section: Articles

    How to cite:
    Marques, S., Nascimiento Ferreira, H., Pires de Morais Nunes, A. T., Pestana Silva, R., & Moreira Sampaio Norton, S. (2017). Two Faces of the Same Coin: A Case Report of Antiphospholipid Syndrome Nephropathy. European Journal of Case Reports in Internal Medicine, 4(3). https://doi.org/https://doi.org/10.12890/2017_000542