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Treatment of mesenteric angina with prolonged anticoagulation in a patient with antiphospholipid (Hughes) syndrome and coeliac artery stenosis

Antiphospholipid (Hughes) syndrome (APS) is a prothrombotic disorder associated with venous and arterial thrombosis. Arterial stenosis, particularly affecting the renal, coeliac and intracerebral arteries, has been observed. Anticoagulation with international normalised ratio ⩾3 may be able to improve hypertension and the renal function. We report a patient with APS and abdominal angina due to coeliac artery stenosis, whose condition improved on prolonged anticoagulation treatment.

A 39-year-old Caucasian woman was diagnosed with systemic lupus erythematosus and secondary Sjogren’s syndrome in 1999. Her lupus anticoagulant tests (dilute Russell viper venom test) were positive more than once. However, no previous thrombosis or pregnancy loss was reported. She was treated with hydroxychloroquine 200 mg once daily and aspirin 75 mg/day. In December 2003, the patient had epigastric …