Myocardial microangiopathy associated with antiphospholipid antibodies

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B R Lauwerys1, M Lambert, J L Vanoverschelde

  • 1Rheumatology Department, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium.

Lupus
|March 10, 2001
PubMed

Insights

Catastrophic antiphospholipid syndrome can cause myocardial thrombotic microangiopathy, rarely seen in living patients. 99mTc-MIBI scintigraphy aids in detecting this cardiac microangiopathy.

Area of Science:

  • Cardiology
  • Immunology
  • Pathology

Background:

  • Myocardial thrombotic microangiopathy is a known post-mortem finding in catastrophic antiphospholipid syndrome (APS).
  • Imaging of cardiac microangiopathy in living patients with APS is rare.

Observation:

  • Two patients with APS antibodies presented with myocardial ischemia.
  • Symptoms included scintigraphic, electrocardiographic, and echocardiographic evidence of ischemia.
  • Coronary angiography was normal in both patients.

Findings:

  • 99mTc-MIBI exercise stress myocardial scintigraphy detected cardiac microangiopathy.
  • Kidney biopsy confirmed thrombotic microangiopathy in one patient.

Implications:

  • This study highlights the utility of 99mTc-MIBI scintigraphy for diagnosing cardiac microangiopathy in APS.
  • Early detection can potentially improve patient outcomes.

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