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Aortoiliac occlusion associated with the lupus anticoagulant. Report of two cases
M Setoguchi1, Y Fujishima, I Abe
1Second Department of Internal Medicine, Kyushu University, Faculty of Medicine, Fukuoka, Japan.
Insights
Aortoiliac occlusion, typically seen in older adults, occurred in two young men due to lupus anticoagulant. This immunoglobulin, usually linked to smaller vessel clots, may also cause severe aortic and iliac artery blockage in younger individuals.
Area of Science:
- Vascular Medicine
- Immunology
- Cardiovascular Pathology
Background:
- Aortoiliac occlusion is a common manifestation of atherosclerosis, primarily affecting elderly populations.
- Risk factors for atherosclerotic thrombosis typically include age, hypertension, hyperlipidemia, and smoking.
Observation:
- Two unique cases of aortoiliac occlusion were identified in young men.
- These patients lacked traditional risk factors for atherosclerotic thrombosis.
Findings:
- The primary identifiable risk factor in both cases was the presence of lupus anticoagulant.
- Lupus anticoagulant, an immunoglobulin, is known to be associated with thromboembolic events.
- This finding suggests lupus anticoagulant may contribute to severe aortoiliac atheromatous occlusion even in the absence of other risk factors.
Implications:
- The study highlights a potential, previously under-recognized association between lupus anticoagulant and severe aortoiliac occlusive disease in young individuals.
- This suggests the need for broader screening for lupus anticoagulant in young patients presenting with unexplained aortoiliac thrombosis.
- Further research is warranted to elucidate the precise mechanisms by which lupus anticoagulant contributes to large artery thrombosis.
Abstract:
Aortoiliac occlusion due to atherosclerosis is known to occur in elderly people. Two unique cases are documented here in which aortoiliac occlusion was observed in young men. These patients had no identifiable risk factors for developing atherosclerotic thrombosis except for the lupus anticoagulant, an immunoglobulin associated with thromboembolic episodes. Although previously the lupus anticoagulant has been reported to cause thrombosis only in relatively small-sized arteries or veins, it may also be associated with aortoiliac atheromatous occlusion in young men.