The Ewha Medical Journal  2013;36(2):149-152

doi:10.12771/emj.2013.36.2.149

Antiphospholipid Syndrome Presenting Variceal Bleeding in Patient with Systemic Anaerobic Bacterial Infection.

Hyeon Ju KANG 1 ; Hye Kyung JUNG ; Mi Yeon KIM ; Min Sun RYU ; So Young AHN ; Hyoung Won CHO ; In Sook KANG ; Seong Eun KIM

Affiliations

+expand

Keywords

Abscess; Antiphospholipid syndrome; Portal vein thrombosis; Variceal bleeding

Country

Republic of Korea

Language

English

Abstract

Antiphospholipid antibody syndrome (APS) is characterized by raised levels of antiphospholipid antibodies (aPL), in association with thrombosis, recurrent fetal loss, and thrombocytopenia. Development of APS is related with idiopathic origin, autoimmune disease, malignancy and, on rare occasions, infection. However, in secondary APS combined with bacterial infections, aPL is usually shown with low titer and rarely associated with thrombotic events. A 52-year-old male was admitted due to pneumonia and multiple hepatosplenic abscesses. He had been treated with proper antibiotics, but he presented ascites and sudden variceal bleeding because of portal vein thrombosis. The bleeding was controlled by endoscopic variceal ligation. Acute portal vein thrombosis was successfully managed by low molecular weight heparin and hepatosplenic abscesses were completely resolved by antibiotics. This case suggests that systemic bacterial infection in immunocompetent patients possibly develops into secondary APS.