Superior vena cava occlusion in a patient with antiphospholipid antibody syndrome

A 55-year-old woman with a lupus like disease, associated with the lupus anticoagulant, was admitted because of facial edema. Her facial swelling was previously attributed to the steroids she had been taking and they were tapered without improvement. Laboratory tests revealed high titers of anticardiolipin antibodies. Computerized tomography of her chest and Doppler ultrasound examination of her neck veins demonstrated a thrombus in the superior vena cava. She was treated with heparin and was maintained with longterm warfarin therapy with uneventful followup. Superior vena cava obstruction should be added to the long list of thromboembolic complications of the antiphospholipid syndrome.