IMMUNOSUPPRESSIVE TREATMENT IN A HEART-TRANSPLANTATION CANDIDATE WITHANTIPHOSPHOLIPID SYNDROME

Dilated cardiomyopathy secondary to a devastating anterior myocardial infarction developed in a young patient with the antiphospholipid anti body syndrome, Due to severe left ventricular failure, heart transplan tation was considered. To reduce antiphospholipid antibody titer, plas mapheresis followed by immunosuppressive treatment with cyclosporin an d azathioprine were attempted in the pretransplant period. The antibod y titer normalized after plasmapheresis, but then rose sharply despite immunosuppressive drugs, This case report underscores the failure of cyclosporin, a treatment not previously reported, to control autoimmun ity in antiphospholipid syndrome. Moreover, progressive renal insuffic iency can develop as a result of the long-term use of this drug.