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Multiple arterial thromboses in a patient with primary antiphospholipid syndrome receiving a bromocriptine therapy

Service d’ Exploration Vasculaire, Hopital Edouard Herriot, Lyon, France, Laboratoire d’ Hemostase, Hopital Edouard Herriot, Lyon, France, ydargaud{at}univ-lyon1.fr

C Pariset

Service de Medecine Interne, Hopital Edouard Herriot, Lyon, France

L Pinede

Service de Medecine Interne, Hopital Edouard Herriot, Lyon, France

L Rugeri

Laboratoire d’ Hemostase, Hopital Edouard Herriot, Lyon, France

I Mohammedi

Service de Reanimation, Hopital Edouard Herriot, Lyon, France

C Trzeciak

Laboratoire d’ Hemostase, Hopital Edouard Herriot, Lyon, France

C Negrier

Laboratoire d’ Hemostase, Hopital Edouard Herriot, Lyon, France

J Ninet

Service d’ Exploration Vasculaire, Hopital Edouard Herriot, Lyon, France, Service de Medecine Interne, Hopital Edouard Herriot, Lyon, France

We report a patient with a previously known primary antiphospholipid syndrome who had life threatening multiple arterial thromboses. The patient experienced a myocardial infarction with intraventricular thrombi under bromocriptine therapy in the puerperium, despite prophylactic low molecular weight heparin therapy. In this patient, no microvascular involvement was identified, thus eliminating the diagnosis of catastrophic antiphospholipid syndrome. Arterial thromboses may be explained by peripheral emboli originating from the intraventricular thrombi. This case emphasizes the necessity of a careful evaluation of the risk-benefit balance of bromocriptine therapy in patients with arterial risk factors. It also emphasizes the need for a correct diagnosis of catastrophic antiphospholipid syndrome allowing to limit the prescription of aggressive therapies.

Key Words: arterial thrombosis • bromocriptine • catastrophic antiphospholipid syndrome • myocardial infarction • primary antiphospholipid syndrome

Lupus, Vol. 13, No. 12, 957-960 (2004)
DOI: 10.1191/0961203304lu2016cr


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