TY - JOUR
T1 - Lupus anticoagulant and ischemic myocardial microangiopathy in rheumatoid arthritis
AU - Ferraccioli, Gianfranco
AU - Zoli, Angelo
AU - Alivernini, Stefano
AU - De Santis, Maria
AU - Verrillo, Alfonso
AU - Loperfido, Francesco
PY - 2006/6
Y1 - 2006/6
N2 - 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.
AB - 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.
KW - Ischemic microangiopathy
KW - Lupus anticoagulant
KW - Rheumatoid arthritis
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U2 - 10.1038/ncpcardio0576
DO - 10.1038/ncpcardio0576
M3 - Article
C2 - 16729012
AN - SCOPUS:33744531367
VL - 3
SP - 339
EP - 343
JO - Nature Clinical Practice Cardiovascular Medicine
JF - Nature Clinical Practice Cardiovascular Medicine
SN - 1743-4297
IS - 6
ER -