A Case of Superior Mesenteric Artery Thrombosis Associated With Transient Elevation of Antiphospholipid Antibodies

Jun Kadono, Maki Inoue, Chiaki Taki, Naoki Ishizaki, Masahiko Osako, R Ishibe, Mineo Tabata, Yutaka Imoto
In: International Surgery · 2015 · vol. 100(9-10) , pp. 1346–1350 · doi:10.9738/intsurg-d-15-00054.1 · W2403081841
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Abstract

Transient elevation of antiphospholipid antibody (APLA) is commonly observed in cases of viral infection; however, it is generally not associated with clinical thromboembolic events. In this report, we present a rare case of superior mesenteric artery (SMA) thrombosis associated with a transient elevation of APLA and discuss its relationship with fibromuscular dysplasia and adenomyosis of the uterus. Furthermore, we discuss the use of anticoagulant therapy in cases with transient elevation of APLA. In this case, a 46-year-old woman with no significant medical history was diagnosed with intestinal stenosis after SMA thrombosis that had been resolved with anticoagulant therapy. Laboratory examination showed elevated levels of anticardiolipin antibody. Resection of the stenosed ileum and hysterectomy for huge adenomyosis were performed. Anticardiolipin antibody level normalized 4 months after the operation. Anticoagulant therapy was withdrawn after anticardiolipin antibody normalized, and the patient has been free from thromboembolic events ever since. Transient elevation of APLA should be kept in mind in all patients with thromboembolic events, including those with no medical history of collagen diseases or infection. In the present case, association with fibromuscular dysplasia and adenomyosis of the uterus is suspected, but further investigation is required. Once the APLA level normalizes with the resolved thrombus, decision of withdrawing the anticoagulant therapy can be considered.

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