T. Naito et al., A case of antiphospholipid antibody syndrome diagnosed after thrombosis ofan arteriovenous shunt, INT J ARTIF, 22(8), 1999, pp. 543-546
A 32-year-old male dialysis patient with lupus nephritis was admitted becau
se of shunt obstruction. The arteriovenous fistula was reconstructed, but o
bstruction recurred twice within several hours after surgery. A high blood
level of anticardiolipin beta(2)-glycoprotein I antibody suggested that shu
nt obstruction was caused by a thrombotic tendency related to the antiphosp
holipid antibody syndrome. Accordingly, for the third shunt procedure, anti
platelet therapy (which had been commenced for systemic lupus erythematosus
) was combined with dalteparin sodium from before surgery and warfarin was
added postoperatively. This regimen prevented shunt obstruction. In conclus
ion, hemodialysis patients who suffer repeated shunt obstruction should be
examined for antiphospholipid antibody syndrome.