Gastrointestinal symptoms as the first manifestation of antiphospholipid syndrome

BMC Gastroenterol. 2021 Apr 1;21(1):148. doi: 10.1186/s12876-021-01736-2.

Abstract

Background: Antiphospholipid syndrome (APS) is an acquired pre-thrombotic autoimmune condition, which produces autoantibodies called antiphospholipid antibodies (APL) against phospholipid-binding plasma proteins. The diagnosis of APS requires at least one of Sapporo standard clinical manifestations and one laboratory criteria (persistently medium/high titer anticardiolipin antibodies, and/or medium/high titer anti-β2-glycoprotein I antibodies, and/or a positive lupus anticoagulant test). Gastrointestinal lesions are rarely reported in APS patients. APS cases with recurrent abdominal pain as the first clinical manifestation are even rarer.

Case presentation: This report describes an APS case with recurrent abdominal pain as the first clinical manifestation of antiphospholipid syndrome. The patient has a history of two miscarriages. Computed tomography of the abdomen confirmed mesenteric thrombosis and intestinal obstruction while laboratory tests for serum antiphospholipid and anti-β2-glycoprotein I antibodies were positive. This led to the diagnosis of APS.

Conclusions: This paper provides useful information on gastrointestinal manifestations and APS, also including a brief literature review about possible gastrointestinal symptoms of APS.

Keywords: Antiphospholipid antibodies; Antiphospholipid syndrome; Intestinal necrosis; Intestinal obstruction; Mesenteric thrombosis.

MeSH terms

  • Antibodies, Anticardiolipin
  • Antibodies, Antiphospholipid
  • Antiphospholipid Syndrome* / complications
  • Antiphospholipid Syndrome* / diagnosis
  • Autoantibodies
  • Humans
  • Thrombosis* / etiology

Substances

  • Antibodies, Anticardiolipin
  • Antibodies, Antiphospholipid
  • Autoantibodies