Primary anti-phospholipid syndrome revealed by superior mesenteric artery ischemia and venous thromboembolic disease: a case report in Burkina Faso.

Abstract

Introduction :
Antiphospholipid syndrome (APS) is defined by the occurrence of venous and arterial thromboses, often multiple, recurrent fetal losses, often accompanied by moderate thrombocytopenia, in the presence of antiphospholipid antibodies (APL). The aim of this work was to describe the clinical observation and follow-up of a case of primary anti-phospholipid syndrome revealed by ischemia of the superior mesenteric artery and venous thromboembolic disease.

Patient and observation :
This was a 16-year-old patient admitted to the visceral surgery department of the Centre Hospitalier Universitaire Yalgado Ouedraogo (CHU YO) in January 2016 for abdominal pain of abrupt onset evolving for 24 hours suggestive of a surgical abdomen. An exploratory laparotomy revealed 110 cm of jejunal necrosis and micro-thrombi in the superior mesenteric artery. Hospitalization was marked by thrombosis of the left femoral vein on the sixth day, followed by proximal pulmonary embolism on the tenth day, and an anti-vitamin k accident involving rectal bleeding on the twenty-eighth day of hospitalization. The antiphospholipid antibody (APL) assay revealed an increase in antibodies to beta 2glycoprotein I (b2GPI). The outpatient course over an eight-year period was favorable, with no recurrence of venous or arterial thromboembolic events, on acenocoumarol 2 mg/day and oral acetylsalicylic acid 100 mg/day.

Conclusion :
Antiphospholipid syndrome (APS) should be systematically investigated during arterial and/or venous thrombosis, especially when the patient does not present conventional risk factors.