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(Radiology. 2001;218:768-771.)
© RSNA, 2001

Gastrointestinal Imaging

Abdominal Thrombotic and Ischemic Manifestations of the Antiphospholipid Antibody Syndrome: CT Findings in 42 Patients1

Shaifali Kaushik, MD, Michael P. Federle, MD, Peter H. Schur, MD, Madhavan Krishnan, MD, Stuart G. Silverman, MD and Pablo R. Ros, MD

1 From the Department of Radiology, University of Pittsburgh Medical Center-Presbyterian Hospital, 200 Lothrop St, Room 4660 CHP MT, Pittsburgh, PA 15213-2582 (S.K., M.P.F., M.K.); and the Departments of Radiology (S.K., S.G.S., P.R.R.) and Medicine (P.H.S.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass. From the 1999 RSNA scientific assembly. Received May 3, 2000; revision requested June 5; revision received July 11; accepted August 15. Address correspondence to M.P.F. (e-mail:federlemp@radserv.arad.upmc.edu).

PURPOSE: To determine the abdominal computed tomographic (CT) findings in patients with antiphospholipid antibody syndrome (APS).

MATERIALS AND METHODS: Retrospective review of medical records from two university medical centers from 1994 through 1997 revealed 215 patients who had a hypercoagulable state attributed to primary or secondary APS. Abdominal CT findings in these patients were reviewed for evidence of large-vessel occlusion or visceral ischemia.

RESULTS: In 42 (19.5%) of 215 patients with APS (age range, 32–65 years; mean age, 42 years), abdominal thromboses or ischemic events were detected at CT. Twenty-two (52%) had major vascular thromboses, including those in the inferior vena cava (n = 10), portal and superior mesenteric veins (n = 7), splenic vein (n = 4), and aorta (n = 1). Thirty-six (86%) patients had abdominal visceral ischemia resulting in renal infarction (n = 22), bowel ischemia (n = 13), splenic infarction (n = 6), pancreatitis (n = 3), hepatic infarction (n = 1), and/or hepatic dysfunction with portal hypertension (n = 1). In some patients, more than one abdominal organ and/or vessel was involved.

CONCLUSION: Patients who have circulating antiphospholipid antibodies are at risk for major abdominal vascular thromboses and organ infarction. Radiologists must be familiar with this syndrome; they may be the first physicians to suggest the diagnosis on the basis of findings of unusual or recurrent sites of thrombosis, especially in young patients.

Index terms: Abdomen, CT, 70.12112, 70.12115 • Antiphospholipid syndrome, 70.659 • Arteries, thrombosis, 95.751 • Lupus erythematosus, 70.612, 80.612 • Veins, thrombosis, 95.751




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