Gastrointestinal hemorrhage and intestinal ischemia associated with anticardiolipin antibodies

Two patients developed unusual causes of severe gastrointestinal hemorrhage associated with anticardiolipin antibodies. One patient bled from small bowel ischemia and mesenteric thrombosis. Another patient bled massively from an ulcer of the descending duodenum which was refractory to standard antiulcer therapy. Ischemia may have contributed to the atypical ulcer presentation in this second patient, which included atypical ulcer location, ulcer refractoriness to standard peptic ulcer therapy, and severe recurrent hemorrhage. In five previously reported cases intestinal infarction associated with anticardiolipin antibodies presented, as it usually presents in patients without anticardiolipin antibodies, as an acute abdomen without acute gastrointestinal bleeding. The current study demonstrates that intestinal ischemia due to thrombosis is in the differential diagnosis of gastrointestinal bleeding in the anticardiolipin antibody syndrome.