Intravenous immunoglobulin to prevent recurrent thrombosis in the antiphospholipid syndrome

The antiphospholipid syndrome (APS) occurs as a primary entity or in associ ation with autoimmune diseases, malignancies, or medications. Conventional treatment for APS-associated thrombosis involves the use of anticoagulants such as aspirin, heparin, and warfarin. Alternative treatment options are l imited. We report on a patient with APS who failed conventional therapy but had clinical improvement and a decline in anticardiolipin (aCL) antibody t iters during treatment with monthly intravenous immunoglobulin (IVIg). Anti cardiolipin antibodies IgG, IgA, and Igm were measured before initiating IV Ig and before each subsequent infusion of IVIg. The patient was also evalua ted for the presence of thromboses during the treatment period. IgG and IgA aCL levels were elevated initially, and there was a significant decrease i n anticardiolipin IgG and IgA levels during treatment without further episo des of thrombosis. Mg may be an alternative therapy for recurrent thrombosi s in the antiphospholipid antibody syndrome.