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Suenaga A, Sawa N, Oshima Y, Ikuma D, Oba Y, Yamanouchi M, Hasegawa E, Mizuno H, Sekine A, Suwabe T, Kono K, Kinowaki K, Ohashi K, Takemura T, Yamaguchi Y, Miyazono M, Atsumi T, Ubara Y. Antiphospholipid Syndrome Nephropathy Related Disease Diagnosed by Assessing Phosphatidylserine-dependent Antiprothrombin Antibodies. Intern Med 2023; 62:757-761. [PMID: 35908966 PMCID: PMC10037018 DOI: 10.2169/internalmedicine.0302-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 42-year-old Japanese woman was admitted for the evaluation of proteinuria. She had a history of four habitual abortions and valvular heart disease, including severe mitral regurgitation and moderate tricuspid regurgitation. A kidney biopsy showed fibrointimal thickening of interlobular arteries, fibrin thrombosis, and associated focal segmental sclerosis. Although the standard test for antiphospholipid (aPL) antibodies was negative, the patient was diagnosed with antiphospholipid syndrome (APS)-related disease by testing for phosphatidylserine dependent anti-prothrombin anticardiolipin antibody, a non-criterial aPL antibody. A kidney biopsy may lead to a diagnosis of APS in patients with negative laboratory test findings for APS.
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Affiliation(s)
- Atsuhiko Suenaga
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
- Department of Nephrology, Saga University School of Medicine, Japan
| | - Naoki Sawa
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Yoichi Oshima
- Department of Internal Medicine, Division of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Japan
| | - Daisuke Ikuma
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Yuki Oba
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Masayuki Yamanouchi
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Eiko Hasegawa
- Department of Internal Medicine, Division of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Japan
| | - Hiroki Mizuno
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Akinari Sekine
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Tatsuya Suwabe
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Kei Kono
- Department of Pathology, Toranomon Hospital, Japan
| | | | - Kenichi Ohashi
- Department of Pathology, Toranomon Hospital, Japan
- Department of Human Pathology, Tokyo Medical Dental University, Japan
| | - Tamiko Takemura
- Department of Pathology, Kanagawa Cardiovascular and Respiratory Center, Japan
| | | | - Motoaki Miyazono
- Department of Nephrology, Saga University School of Medicine, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Hokkaido University, Japan
| | - Yoshifumi Ubara
- Department of Nephrology and Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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