Digestive Diseases and Sciences

, Volume 38, Issue 6, pp 1152–1155 | Cite as

Splenic infarction associated with anticardiolipin antibodies in a patient with acquired immunodeficiency syndrome

  • Mitchell S. Cappell
  • Todd Simon
  • Moti Tiku
Case Report


Although patients with AIDS frequently develop high titers of anticardiolipin antibodies, the clinical significance of this laboratory abnormality in AIDS patients is unknown. A 33-year-old female with AIDS, a prior small cerebrovascular accident, thrombocytopenia, and a coagulopathy suddenly developed left upper quadrant pain and tenderness due to splenic infarction associated with a high titer of anticardiolipin antibodies. Possible clinical manifestations of anticadiolipin antibodies in this patient include recurrent thromboembolism, coagulopathy, and thrombocytopenia. This case report suggests that anticardiolipin antibodies are associated with splenic infarction and that anticardiolipin antibodies associated with AIDS may sometimes be clincally signifcant.

Key Words

anticardiolipin antibodies lupus anticoagulant systemic lupus erythematosus vasculitis autoimmune diseases human immunodeficiency virus acquired immunodeficiency syndrome splenc infarction thromboembolism 


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  1. 1.
    Canoso RT, Zon LI, Groopman JE: Anticardiolipin antibodies associated with HTLV-IIIinfection. Br J Haemotol 65:495–498,1987Google Scholar
  2. 2.
    Cohen AJ, Philips TM, Kessler CM: Circulating coagulation inhibitors in the acquired immunodeficiency syndrome. Ann Intern Med 104:175–180, 1985Google Scholar
  3. 3.
    Stimmler MM, Quismorio FP Jr, McGehee WG, Boylen T, Sharma OP: Anticardiolipin antibodies in acquired immunodeficiency syndrome. Arch Intern Med 149:1833–135, 1989Google Scholar
  4. 4.
    Panzer S, Stain C, Hartl H, Ducczak R, Lechner K: Anticardiolipin antibodies are elevated in HIV-1 infected haemophiliacs but do not predict for disease progression. Thromb Hemost 61:81–85, 1989Google Scholar
  5. 5.
    Cappell MS, Seibold JR: Mesenteric thrombosis associated with anticardiolipin antibodies in a patient with systemic lupus erythematosus. Am J Gastroenterol 87:520–522, 1992Google Scholar
  6. 6.
    Harris EN, Hughes GRV, Gharavi EA: Antiphospholipid antibodies: An elderly statesman dons new garments. J Rheumatol 14(suppl 134):208–213, 1987Google Scholar
  7. 7.
    Kalunian KC, Peter JB, Middlekauff HR, Sayre J, Ando DG, Mangotich M, Hahn BH: Clincal significance of a single test for anti-cardiolipin antibodies in patients with systemic lupus erythematosus. Am J Med 85:602–608, 1988Google Scholar
  8. 8.
    Love PE, Santoro SA: Antiphospholipid antibodies: Anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus (SLE) and in non SLE disorders: Prevalence and clincal significance. Am Inten Med 112:682–698, 1990Google Scholar
  9. 9.
    Jaroch MT, Broughan TA, Hermann RE: The natural history of splenic infarction. Surgery 100:743–750, 1986Google Scholar
  10. 10.
    O'Keefe JH Jr, Holmes DR Jr, Schaff HV, Sheedy PF II, Edwards WD: Thromboembolic splenic infarction. Mayo Clin Proc 61:967–972, 1986Google Scholar
  11. 11.
    Freudenberger RS, Cappell MS, Hutt, DA: Intestinal infarction after intravenous cocaine administration. Ann Intern Med 113:715–716, 1990Google Scholar
  12. 12.
    Williams LF: Mesenteric ischemia. Surg Clin North Am 68:331–353, 1988Google Scholar
  13. 13.
    Arnold MH, Schrieber L: Splenic and renal infarction in systemic lupus erythematosus: Association with anticardiolipin antibodies. Clin Rheumatol 7:406–410, 1988Google Scholar
  14. 14.
    Obarski TP, Stoller JK, Weinstein C, Hayden S: Splenic infarction: A new thrombotic manifestation of the circulating lupus anticoagulant. Cleveland Clin J Med 56:174–176, 1989Google Scholar
  15. 15.
    Alarcon-Segovia D, Deleze M, Oria CV, Sanchez-Guerrero J, Gomez-Pacheco L, Cabiedes J, Fernandez L, de Leon SP: Antiphospholipid antibodies and the antiphospholipid syndrome in systemic lupus erythematosus: A prospective analysis of 500 consecutive patients. Medicin 68:353–365, 1989Google Scholar
  16. 16.
    Eldrup-Jorgensen J, Brace L, Flanigan P, Schwarcz TH, Fritsma G, Meyer JP, Schuler JJ: Lupus-like anticogulants and lower extremity arterial occlusive disease. Circulation 80(suppl II):54–58, 1989Google Scholar
  17. 17.
    Gladman DD, Urowitz MB: Venous syndromes and pulmonary embolism in systemic lupus erythematosus. Ann Rheum Dis 39:340–343, 1980Google Scholar
  18. 18.
    Levine SR, Deegan MJ, Futrell N, Welch KMA: Cerebrovascular and neurologic disease assciated with antiphospholipid antibodies: 48 cases. Neurology 40:1181–1189, 1990Google Scholar
  19. 19.
    Kleiner RC, Najarian LV, Schatten S, Jabs DA, Patz A, Kaplan HJ: Vaso-occlusive retinopathy associated with antiphospholipid antibodies (lupus anticoagulant retinopathy). Ophthalmology 96:896–904, 1989Google Scholar
  20. 20.
    Hamsten A, Norberg R, Bjorkholm M, de Faire U, Holm G: Antibodies to cardiolipin in young survivors of myocardial infarction: An association with recurent cardiovascular events. Lancet 1:113–116, 1986Google Scholar
  21. 21.
    Hadi HA, Treadwell EL: Lupus anticoagulant anticardiolipin antibodies in pregnancy: A review: I. Immunochemistry and clinical implications. Obstet Gynecol Surv 45:780–785, 1990Google Scholar
  22. 22.
    Petri M, Rheinschmidt M, Whiting-O'Keefe Q, Hallmann D, Corash L: The frequency of lupus anticoagulant in systemic lupus erythematosus: A study of sixty consecutive patients by activated partial thromboplastin time, Russell viper venom time, and anticardiolipin antibody level. Ann Intern Med 106:524–531, 1987Google Scholar
  23. 23.
    Asherson RA, Thompson RPH, Maclachlan N, Baguley E, Hicks P, Hughes GRV: Budd-Chiari syndrome, visceral arterial occlusions, recurrent fetal loss and the lupus anticoagulant in systemic lupus erythematosus. J Rheumatol 16:219–224, 1982Google Scholar
  24. 24.
    Clark WF, Tevaarwerk GJM, Reid BD: Human plateletimmune complex interaction in plasma. J Lab Clin Med 100:917–931, 1982Google Scholar
  25. 25.
    Mueh JR, Herbst KD, Rapaport SI: Thrombosis in patients with the lupus anticoagulant. Ann Intern Med 92:156–159, 1980Google Scholar
  26. 26.
    Angles-Cano E, Sultan Y, Clauvel JP: Predisposing factors to thrombosis in systemic lupus erythematosus: Possible relation to endothelial cell damage. J Lab Clin Med 94:312–323, 1979Google Scholar
  27. 27.
    Danao T, Camara EG: The anticardiolipin syndrome. Am Fam Physician 39:107–110, 1989Google Scholar
  28. 28.
    Pengo V, Thiagarajan P, Shapiro SS, Heine MJ: Immunological specificity and mechanism of action of IgG lupus anticoagulants. Blood 70:69–76, 1987Google Scholar
  29. 29.
    Sanfelippo MJ, Drayna CJ: Prekallikrein inhibition associated with the lupus anticoagulant: Mechanism of thrombosis. Am J Clin Pathol 77:275–279, 1982Google Scholar
  30. 30.
    Lafeuillade A, Delbeke E, Chaffanjon P, Aubert L, Dhiver C, Gastaut JA, Quilichini R: Value of anticadiolipin assay in human immunodeficiency infection. Presse Med 19:1225–1227, 1990Google Scholar
  31. 31.
    Matsuura E, Igarashi Y, Fujimoto M, Ichikawa K, Koike T: Anticardiolipin cofactor (s) and differential diagnosis of autoimmune disease. Lancet 336:177–178, 1990Google Scholar
  32. 32.
    Coll J, Yazbeck H, Garces JM, Berges A, Prats F, Rubies-Prat J: Anticardiolipin antibodies andPneumocystis carinii in patients with AIDS. J Infect 21:120, 1990 (letter)Google Scholar
  33. 33.
    Masala C, Sorice M, Di Prima MA, Misasi R, Contini C, Vullo V: Anticardiolipin antibodies andPneumocystis carinii pneumonia. Ann Intern Med 110:749, 1989 (letter)Google Scholar
  34. 34.
    Rivera J, Montegudo I, Lopez-Longo J, Maldonado E, Carreno L: Anticadiolipin antibodies in drug addicted patients with AIDS. Ann Rheum Dis 50:338, 1991 (letter)Google Scholar
  35. 35.
    Calabrese LH: The rheumatic manifestations of infection with the human immunodeficiency virus. Semin Arthritis Rheum 18:225–239, 1989Google Scholar
  36. 36.
    Sergent J: Vasculitis associated with viral infection. Clin Rheum Dis 6:339–350, 1980Google Scholar
  37. 37.
    Berman A, Espinoza LR, Diaz JD, Aguilar JL, Rolando T, Vasey FB, Temain BF, Lockey RF: Rheumatic manifestations of human immunodeficiency virus infection. Am J Med 85:59–64, 1988Google Scholar
  38. 38.
    Kaye BR: Rheumatologic manifestations of infection with human immunodeficiency virus (HIV). Ann Intern Med 111:158–167, 1989Google Scholar
  39. 39.
    Calabrese LH, Estes M, Yen-Lieberman B, Proffitt MR, Tubbs R, Rishleder AJ, Levin KH: Systemic vasculitis in association with human immunodeficienct virus infection. Arthritis Rheum 32:569–576, 1989Google Scholar

Copyright information

© Plenum Publishing Corporation 1993

Authors and Affiliations

  • Mitchell S. Cappell
    • 1
  • Todd Simon
    • 1
  • Moti Tiku
    • 1
  1. 1.Divisions of Gastroenterology & Rheumatology, Department of MedicineUMDNJ-Robert Wood Johnson (formerly Rutgers) Medical SchoolNew Brunswick

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