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Anticardiolipin antibodies in a patient with Crohn's disease and thrombosis
J L Vianna1, D P D'Cruz, M A Khamashta
1Lupus and Arthritis Unit, Rayne Institute, St. Thomas' Hospital, London, UK.
Insights
Thrombosis is a rare complication of inflammatory bowel disease. This case report details a patient with antiphospholipid syndrome (APS) who developed Crohn's disease, suggesting a potential link between these conditions and anticardiolipin antibodies.
Area of Science:
- Internal Medicine
- Immunology
- Gastroenterology
Background:
- Thrombosis is an uncommon complication of inflammatory bowel disease (IBD).
- Antiphospholipid syndrome (APS) is characterized by thrombosis, fetal loss, and thrombocytopenia, associated with antiphospholipid antibodies.
- Coagulation alterations are implicated in IBD-related thrombosis.
Observation:
- A 21-year-old female presented with recurrent thrombosis and anticardiolipin antibodies (aCL).
- The patient subsequently developed Crohn's disease, a form of IBD.
- Genetic analysis revealed the presence of HLA-DR7 and DRw53, markers associated with APS.
Findings:
- This case presents the first reported association between APS and Crohn's disease.
- Anticardiolipin antibodies (aCL) may play a role in the thrombotic events observed in this patient.
- The presence of specific HLA types (HLA-DR7, DRw53) further supports a potential link.
Implications:
- This case highlights the importance of considering APS in patients with IBD and recurrent thrombosis.
- Further research is warranted to elucidate the potential pathogenic mechanisms linking APS, IBD, and thrombotic events.
- Understanding this association may lead to improved diagnostic and therapeutic strategies for affected patients.
Abstract:
Thrombosis is an uncommon though well recognized complication of inflammatory bowel disease, for which various coagulation alterations have been described as possible causes. Antiphospholipid syndrome (APS) is defined as the association of thrombosis, fetal loss and thrombocytopenia with anticardiolipin antibodies (aCL) and/or lupus anticoagulant (LA). We describe a case of a 21-year-old female with recurrent thrombosis associated with aCL who went on to develop Crohn's disease. Tissue typing done in this patient revealed the presence of the HLA-DR7, DRw53, which previous studies have shown to be found in increased frequencies in APS patients. To our knowledge, this is the first report of an association between these two clinical conditions and, in this particular case, aCL may be implicated in the thrombotic events.