Abstract

PRIMARY ANTI-PHOSPHOLIPID SYNDROME (APLS): A CASE REPORT

Nauman Ismat Butt*, Fahmina Ashfaq, Farhan Mustafa, Bilal Rasheed Khan and Aniqa Anser

ABSTRACT

Anti-Phospholipid Syndrome (APLS) is manifested by recurrent arterial or venous thrombosis and obstetric complications in the presence of Anti-Phospholipid antibodies. The current case is of a 33-year old lady who presented with a second episode of Deep Vein Thrombosis of the left lower limb diagnosed by Doppler ultrasound showing thrombosis of left common femoral and politeal vein. She had been fully mobile, not taking any contraceptive pill and had no recent pregnancy. The first episode of Deep Vein Thrombosis involved bilateral lower limbs, occurring 1 year ago during her post-partum phase and was treated with Rivaroxaban for 3 months. There was a significant history of recurrent abortions over last 12 years, 2 abortions in the third trimester and 5 in first trimester. On investigation, she had thrombocytopenia and prolonged APTT with positive Lupus Anticoagulant and positive Anti-Cardiolipin antibodies. She was diagnosed as having Primary Anti-phospholipid Syndrome and was started on Warfarin with a target INR of 2-3.

Keywords: Primary Anti-phospholipid Syndrome, Recurrent Abortions, Deep Vein Thrombosis, Lupus Anticoagulant, Warfarin.