Lupus anticoagulant and ischemic myocardial microangiopathy in rheumatoid arthritis

Gianfranco Ferraccioli, Angelo Zoli, Stefano Alivernini, Maria De Santis, Alfonso Verrillo, Francesco Loperfido

Research output: Contribution to journalArticlepeer-review


Background: A 49-year-old man presented at a hospital with an arthritic flare-up and stress dyspnea with a cough. He had a 5-year history of symmetrical polyarthritis, for which he was prescribed 5-15 mg prednisolone daily. He was subsequently diagnosed with rheumatoid arthritis and prescribed 20 mg methotrexate weekly, 3 mg/kg ciclosporin daily and 5 mg prednisolone daily. Infliximab therapy was initiated after 3 months because of persistent joint pain and inflammation. Six months later, however, the patient was readmitted to hospital with a new arthritic flare-up, acute retrosternal chest pain and stress dyspnea. Investigations: Laboratory analyses, electrocardiography, chest radiography, high-resolution CT, echocardiography, technetium-99m-labeled (99mTc)-methoxyisobutyl-isonitrile stress myocardial scintigraphy and coronary angiography. Diagnosis: Lup us anticoagulant and ischemic myocardial microangiopathy. Management: Drug therapy with prednisolone, methotrexate, anakinra, aspirin and clopidogrel.

Original languageEnglish
Pages (from-to)339-343
Number of pages5
JournalNature Clinical Practice Cardiovascular Medicine
Issue number6
Publication statusPublished - Jun 2006


  • Ischemic microangiopathy
  • Lupus anticoagulant
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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