A young female is suffering from, recurrent aboions and thrombosis of deep veins, thrombocytopenia and a recent MI. What is the most likely diagnosis?
Three or more organ thromboses developing in less than a week is the cornerstone of C.A.P.S (Catastrophic antiphospholipid antibody syndrome). However, in the given question no time frame is mentioned and this is there by ruled out. Clinical manifestations of heterozygous protein C deficiency include Venous Thrombo-Embolism and warfarin induced skin necrosis (WISN). Whether the risk of pregnancy loss is increased in this disorder is controversial. Heterozygous protein C deficiency does not appear to be associated with an elevated risk of aerial thrombosis and this patient had TTP should have features of kidney involvement and stroke like features. Primary anti-phospholipid antibody syndrome leads to hypercoagulability and recurrent thrombosis can affect viually any organ system, including the following :- Peripheral venous system (deep venous thrombosis) Central nervous system (cerebrovascular accident, sinus thrombosis) Hematologic (thrombocytopenia, hemolytic anemia) Obstetric (pregnancy loss, eclampsia) Pulmonary (pulmonary embolism, pulmonary hypeension) Dermatologic (livedoreticularis, purpura, infarcts/ ulceration) Cardiac (Libman-Sacks valvulopathy, Myocardial Infarction) Ocular (amaurosis, retinal thrombosis) Adrenal (infarction/hemorrhage) Musculoskeletal (avascular necrosis of bone)
Catastrophic anti - phospholipid antibody syndrome
Primary anti - phospholipid antibody syndrome
TTP
Protein C deficiency
Systemic Lupus Erythematous