[Primary antiphospholipid syndrome of fatal course and osteoarticular cytosteatonecrosis]

Osteoarticular Manifestations of Antiphospholipid Syndrome

In conclusion, arthralgias represent a rather common osteoarticular manifestation of primary and secondary APS, while arthritis is mainly described in SLE-related APS. Osteonecrosis is frequently described in association with aPL in patients with and without autoimmune disorders. The presence of osteonecrosis in primary APS patients in the absence of corticosteroid use suggests an association between osteonecrosis and APS. Clinicians should be aware of this possible clinical manifestation of APS, because early diagnosis may lead to early management. A systematic screening for aPL in all cases with diagnosed osteonecrosis in the absence of precipitating factors should be considered.

Avascular Necrosis of Bone Associated With Primary Antiphospholipid Syndrome

We describe, the case of a 34-year-old mestizo Mexican woman with previous history of fetal loss, deep vein thrombosis that developed avascular necrosis (AVN) of the right knee with strong positive levels of anticardiolipin antibodies (aCL) IgG and IgM. AVN of bone in association with aCL has been seen principally in systemic lupus erythematosus patients. However, few cases have been reported of AVN as a clinical manifestation of primary antiphospholipid syndrome. A review of the association of aCL and AVN in patients with systemic lupus erythematosus, primary antiphospholipid syndrome, and idiopathic osteonecrosis is presented.