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Primary antiphospholipid syndrome and chronic disseminated intravascular coagulation: the differences and the
H C Lee1, J S Groothuis, W J Schlueter
1Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska.
Abstract:
A middle aged woman with a medical history of recurrent spontaneous abortions and chronic leg ulcers presented with a pulmonary embolism and inferior vena caval thrombosis. Primary antiphospholipid syndrome (PAPS) was diagnosed by evidence of extremely high titers of anticardiolipin IgG and IgM, typical clinical features and the absence of other autoimmune diseases. Multiple coagulation parameters suggested chronic disseminated intravascular coagulation (DIC). It is important to distinguish PAPS from true chronic DIC as the underlying causes, treatment and prognosis differ greatly. In describing this case of PAPS presenting hematologically as a chronic DIC, we offer a discussion of the means to distinguish between these two coagulopathies and briefly discuss their treatments.