A case of antiphospholipid antibody syndrome diagnosed after thrombosis ofan arteriovenous shunt

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.