Case Report: Recurrent coronary in-stent restenosis as the primary manifestation of non-criteria antiphospholipid syndrome confirmed by anti-phosphatidylserine/prothrombin IgM antibodies.
Tuo M, Li Y, Shi Z, Ma M, Feng Y, Yu J (0000). Case Report: Recurrent coronary in-stent restenosis as the primary manifestation of non-criteria antiphospholipid syndrome confirmed by anti-phosphatidylserine/prothrombin IgM antibodies.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1852153
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📝 摘要
BACKGROUND: A 47-year-old female with no traditional CAD risk factors developed recurrent in-stent restenosis (ISR) one year after LAD stenting. She had recurrent pregnancy loss, chronic urticaria, anemia, and proteinuria, with negative conventional antiphospholipid antibodies. CASE: After second stenting, aPS/PT IgM was elevated (51.65 U/mL), supporting the diagnosis of non-criteria APS. Thromboelastography (TEG) showed decreased R time, increased MA and CI, suggestive of a hypercoagulable state. Warfarin (INR 2-3) and hydroxychloroquine (200 mg bid) plus DAPT led to no chest pain recurrence and stent patency at 21-month follow-up. CONCLUSIONS: Recurrent ISR without traditional risk factors should raise suspicion for non-criteria APS. A moderately elevated aPS/PT IgM may serve as a diagnostic clue. Anticoagulation plus immunomodulation may help prevent further thrombotic events.