Antiphospholipid Syndrome and the Aorta: A Rare Presentation

To the Editor: Antiphospholipid syndrome (APS) is a disorder of coagulation that is usually manifested by arterial or venous thrombosis, or pregnancy-related complications such as miscarriage, stillbirth, preterm delivery, or severe preeclampsia1. The syndrome occurs due to the autoimmune production of antibodies against the cell membrane phospholipid. A 39-year-old woman presented to the emergency department with severe abdominal pain. An abdominal computed tomography (CT) angiogram showed complete occlusion of the distal abdominal aorta from the origin of the left renal artery, common and external iliac artery occlusion, extensive infarcts of kidneys and spleen, and a superior mesenteric artery thrombus (Figures 1 and 2). Figure 1. Abdominal computed tomography coronal slice shows large aortic thrombus extending infrarenally. Figure 2. Axial computed tomography reveals large aortic thrombus and left renal infarcts. She had a history of intermittent left upper-quadrant abdominal pain with radiation to the back with nausea and diapheresis. Her history was significant for hypertension, a remote history of peptic … Address correspondence to Dr. Shroff; E-mail: anjali.shroff{at}gmail.com