Abdominal Pain-An Unusual Case of Anti-Phospholipid Syndrome

Abstract

Antiphospholipid Syndrome (APS), an autoimmune disease associated with hypercoagulability, commonly presents as arterial and/or venous thrombosis, recurrent spontaneous abortions, and moderate thrombocytopenia. It can manifest as a standalone syndrome or a manifestation of a primary systemic disease. The incidence and prevalence of APS without an acquired cause is not well known, although some estimates show around 5 new cases per 100,000 persons per year. Antiphospholipid antibodies (APLA) include anti-cardiolipin, Lupus anticoagulant (LA), and antibeta-2 glycoproteins which are responsible for the underlying pathophysiology. APS is known to be associated with SLE, connective tissue disorders, various autoimmune diseases, malignancies, HIV, and drugs. Anti-cardiolipin antibody causing thrombosis represents a spectrum of APS which is usually associated with an acquired condition and rarely presents as a primary syndrome. We present the case of an African American female, aged 30, with an atypical presentation of a thrombotic episode and the presence of anti-cardiolipin antibodies without any associated secondary cause. Our case stands out because of the primary nature of APS and the atypical presentation with abdominal signs, both of which are rare and constitute only 1.5% of cases of APS. Sharp clinical suspicion with prompt diagnosis can potentially prevent progression to a catastrophic event.