Mesenteric venous thrombosis in a patient with antiphospholipid syndrome and systemic lupus erythematosus

Background: Antiphospholipid antibodies (aPL) are associated with an increased risk of venous thrombosis and can occur in patients without any associated conditions, or in those with autoimmune disorders, such as systemic lupus erythematosus (SLE). Mesenteric venous thrombosis (MVT) is one of the clinical manifestations of antiphospholipid syndrome (APS), and it has rarely been reported in patients with SLE.

Objective: To report a case of SLE complicated by APS and MVT.

Method: A 28-year-old woman with a history of SLE and lupus nephritis was admitted with nonspecific abdominal symptoms. The working diagnosis was severe SLE and paralytic ileus because of primary peritonitis.

Result: Nine days after she did not respond to symptomatic treatment, exploratory laparotomy revealed MVT and further coagulation work-up was diagnostic for APS. Despite treatment, she died because of complications of SLE and APS.

Conclusion: Though rare, MVT should be considered in patients with SLE and/or APS. The diagnosis of MVT requires a high index of suspicion, and early aPL testing for SLE patients is highly recommended to reduce the morbidity and mortality associated with the condition.