[Antiphospholipid syndrome--primary or secondary? Therapeutic problem]

A 44-year old woman hospitalized because of chest pain, pleuropneumonic lesions and high temperature is described. Disease of connective tissue was suspected because of symptoms (fever, chest pain) aggravated despite antibioticotherapy. During diagnostic procedures hypoxemia was observed and thrombotic lesions were discovered in the right popliteal vein and in numerous pulmonary arteries. Pulmonary thrombosis was recognised and patient was admitted to the Intensive Care Unit. Anti-ds.-DNA antibodies were not found but anticardiolipin (aCL) antibodies and lupus anticoagulant (LA) were present in high concentrations in serum. We didn't find all symptoms required for SLE diagnosis. Anticoagulant treatment was effective and we recognised primary antiphospholipid syndrome (APS). It is a less frequent syndrome than "secondary APS" connected with systemic lupus erythematosus. Patient should be treated with anticoagulant drugs and observed whether symptoms of SLE would appear.