ABSTRACT
It is quiet rare that transient high level of elevated antiphospholipid (aLP) antibodies are triggered by infective endocarditis(IE). We report a young woman who went to hospital because of fever was diagnosed with IE, she was suffering from lower and upper arterial thrombosis, tests showed that anticardiolipin and anti-beta2-glycoprotein(GP)-1 IgM antibodies elevated highly. She had mitral valve replacement surgery, echocardiography detected vegetation on mitral valve, multiple blood culture showed negative, after treatment of antibiotics,the second cardiac surgery and warfarin, the patient got stable condition and the upper limb arterial thrombosis disappeared. Three months later, aLP antibodies tests came back negative. This case illustrate that IE could lead to transient high level of elevated aLP antibodies, does that increase the risk of thrombosis of IE patient is unknown, what if we find that phenomenon earlier and prescribe anticoagulant drugs, that need more observation.
ABSTRACT
ObjectiveTo observe nailfold capillary changes in a cohort of conncctive tissue disease ( CTD ) with Raynaud's phenomenon (RP) and to explore the diagnostic value of nailfold videocapillaroscopy (NVC) in systemic sclerosis(SSc).MethodsSixty CTD patients with RP divided into SSc group (n =36) and non-SSc group ( n =24) were referred to an experienced operator for NVC.ResultsThe patients had decreased capillary loops in SSc group with the capillary diameter more enlarged in SSc group than nonSSc group.The number of patients in SSc group with giant capillaries was 14,while 3 in non-SSc group.There were 23 patients with haemorrhagcs in SSc group and 9 in non-SSc group.The number of patients with severe effusion was 15 in SSc group,while 2 in non-SSc group.By using the ROC curves,indexes with AUC at least 0.7 of the input capillary diameter,the output capillary diameter,the middle capillary diameter,blood color and effusion for the diagnostic cutoff points were 18.5 μm,24.5 μm,19.5μm,deep red and severe effusion.With at least 2 out of the top 3 indexes,the diagnostic sensitivity and specificity of SSc were higher.ConclusionsCTD Patients with RP of SSc have less capillary loops,more enlarged capillaries,more giant capillaries, moresevereeffusionandmorehaemorrhagesthannon-SScpatients. The characteristics of nailfold capillary changes in SSc patients with RP can be helpful tor the diagnosis and the differential diagnosis of SSc.