Antiphospholipid syndrome complicated with pulmonary embolism: report of five cases and review of literature

Abstract

Objective To improve the understanding of clinical diagnosis and treatment of antiphospholipid syndrome (APS) complicated with pulmonary embolism (PE). Methods Five cases of APS complicated with PE in the last two years were reported, and the literatures were reviewed. The pathogenesis, diagnosis, and treatment of APS complicated with PE were discussed. Results The five patients were diagnosed as PE by CT pulmonary angiography,and their plasma anticardiolipin antibodies were positive. They were a female and four males. Concomitant lower extremity deep venous thrombosis was found in three cases, and concomitant pulmonary hypertension was found in two cases. The patients were treated with low molecular weight heparin as the initial treatment and warfarin as the maintenance treatment. The clinical outcome was satisfied. Conclusions For the patients with unexplained PE or lower extremity deep venous thrombosis, rheumatoid antibodies and antiphospholipid antibodies should be routinely screened, so that APS can be early found. If APS is diagnosed, after weighing the risk of bleeding, long-term or even life-long warfarin anticoagulation is needed to reduce the recurrence rate of thrombosis and incidence of fatal PE and pulmonary hypertension. Key words: Antiphospholipid syndrome; Pulmonary embolism