“Non-criteria” antiphospholipid syndrome and autoimmune hemolytic anemia: a case report

Excerpt

Antiphospholipid syndrome (APS) is characterized by a moderate to high titer of antiphospholipid antibody (aPL) and usually presents as recurrent arterial, venous thrombosis, and spontaneous abortion [1]. “Non-criteria” APS is proposed when certain patients do not fulfill the diagnostic criteria for APS and are, therefore, inadequately excluded from the diagnosis. Autoimmune hemolytic anemia (AIHA) is usually associated with systemic lupus erythematosus (SLE) and is one of the clinical criteria for SLE [2]. Presently, AIHA is not one of the diagnostic criteria for APS [1]. It was reported that lupus anticoagulant (LA), IgM anticardiolipin antibodies (aCL), and IgM anti-β2 glycoprotein I antibodies (anti-β2GPI) positivity seems to be associated with an increased risk of AIHA [3]. However, there have been no previous reports of AIHA associated with IgA aCL and anti-β2GPI in “non-criteria” APS. Here, we describe a case of a patient who presented with “non-criteria” APS and AIHA, a very rare combination. Our case demonstrates that though rare, the combined occurrence of “non-criteria” APS with AIHA is possible. …