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Myocardial microangiopathy associated with antiphospholipid antibodies

Rheumatology Department, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

M Lambert

General Internal Medicine Department, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

J-L Vanoverschelde

Cardiology Department, Cliniques Universitaires Saint-Luc, Université

J-P Cosyns

Pathology Department, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

F A Houssiau

Rheumatology Department, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium

Myocardial thrombotic microangiopathy is a well described post-mortem finding in patients with the catastrophic antiphospholipid (APL) syndrome. However, it has been only very rarely imaged in living patients. Here, we report two patients with APL antibodies presenting with scintigraphic, electrocardiographic and/or echocardiographic evidence of (sub)acute myocardial ischaemia, despite a normal coronary angiography. Formal proof of a thrombotic microangiopathy was obtained by a kidney biopsy in one patient. We emphasize the value of 99mTc-MIBI (2-methoxy isobutyl isonitrile) exercise stress myocardial scintigraphy for the detection of cardiac microangiopathy associated with the APL syndrome.

Key Words: thrombotic microangiopathy • antiphospholipid syndrome • heart • imaging • scintigraphy • SLé

Lupus, Vol. 10, No. 2, 123-125 (2001)
DOI: 10.1191/096120301666383277


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