SYSTEMIC THROMBOSIS IN PATIENTS WITH ANTIPHOSPHOLIPID ANTIBODIES - LESION DISTRIBUTION AND IMAGING FINDINGS

OBJECTIVE. The purpose of this study was to determine the patterns of non-CNS thromboses in patients with a hypercoagulable state associated with antiphospholipid antibodies (APA). MATERIALS AND METHODS. A sear ch of our institution's clinical coagulation and immunology laboratori es' records of patients examined from January 1993 to January 1996 rev ealed 1290 patients with APA. Computerized records of radiologic studi es were reviewed for evidence of thrombotic events, which were found i n 93 patients (49 males and 44 females; average age, 40 years). The an atomic distribution of thrombotic events was recorded. RESULTS. Fifty- five patients (59%; 29 males and 26 females; average age, 44.2 years) had solely venous thromboses, 26 patients (28%; 15 males and 11 female s; average age, 33.1 years) had solely arterial thromboses, and 12 (13 %; 5 males and 7 females; average age, 35.4 years) had both types of e vents. Deep vein thrombosis (DVT) of the legs was the most common find ing, occurring in 45 patients (48%). Six patients had recurrent DVT. O ther sites of venous thrombotic events included pulmonary embolism, 30 patients (32%); thoracic veins (superior vena cava, subclavian vein, or jugular vein), 10 patients (11%); and abdominal or pelvic veins, 18 events in 11 patients (12%). Sites of arterial thromboses included ar teries supplying the upper limbs (great vessels arising from the aorta or the brachial, radial, ulnar, or digital arteries), 15 events in 12 patients (13%); aorta, one patient (1%); abdominal or pelvic arteries , 11 events in eight patients (9%); and arteries supplying the lower l imbs (femoral or popliteal arteries), seven patients (8%). CONCLUSION. Venous thromboses were more common than arterial thromboses in our pa tient group, with DVT being the most common. However, thromboses in si tes that are unusual for the general population were also relatively c ommon. APA should be suspected in patients with thromboses in unusual sites or recurrent thromboses of an otherwise unexplained cause.