Celiac trunk thrombosis in a patient with antiphospholipid syndrome induced by median arcuate ligament compression: a case presentation and literature review.

Abdominal pain Anticoagulant therapy Antiphospholipid syndrome Median arcuate ligament syndrome Thrombosis

Journal

Rheumatology international
ISSN: 1437-160X
Titre abrégé: Rheumatol Int
Pays: Germany
ID NLM: 8206885

Informations de publication

Date de publication:
27 Sep 2023
Historique:
received: 06 04 2023
accepted: 24 08 2023
medline: 27 9 2023
pubmed: 27 9 2023
entrez: 27 9 2023
Statut: aheadofprint

Résumé

Median arcuate ligament syndrome (MALS) is a rare disorder caused by the compression of the celiac axis by the fibrous structure of the diaphragm called the median arcuate ligament. Patients with MALS are usually undiagnosed unless characteristic symptoms such as nausea and vomiting, postprandial pain, and weight loss are presented. We report a case of a 29-year-old patient diagnosed with MALS and secondary antiphospholipid syndrome (APS) that developed celiac trunk, common hepatic artery and splenic artery thrombosis. There is not enough information on MALS as a trigger of thrombosis in predisposed patients such as those with APS. However, the case gives rise to suspicion and highlights the diagnostic processes, especially for patients with APS presenting postprandial abdominal pain and weight loss. This review likewise aims at the importance of Doppler ultrasonography as a screening tool and computer tomography (CT) or magnetic resonance (MR) both in the angiography variant, especially to diagnose confirmation and underlying treatment options.

Identifiants

pubmed: 37755478
doi: 10.1007/s00296-023-05448-6
pii: 10.1007/s00296-023-05448-6
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s).

Références

Iqbal S, Chaudhary M (2021) Median arcuate ligament syndrome dunbar syndrome. Cardiovasc Diagn Ther 11:1172–1176. https://doi.org/10.21037/cdt-20-846
doi: 10.21037/cdt-20-846 pubmed: 34815969 pmcid: 8569275
Almeida JL, Coelho MN, Armas I (2022) Median arcuate ligament syndrome: a case report of a rare disease. Int J of Surgery Case Reports 90:106686. https://doi.org/10.1016/j.ijscr.2021.106686
doi: 10.1016/j.ijscr.2021.106686
Hanaki T, Sakamoto T, Yata S (2021) Successful interventional radiology for acute median ligament syndrome after pancreaticoduodenectomy. Cureus. https://doi.org/10.7759/cureus.13540
doi: 10.7759/cureus.13540 pubmed: 33796419 pmcid: 8006561
Lainez RA, Richardson WS (2013) Median arcuate ligament syndrome: a case report. Ochsner J 13(4):561–564
pubmed: 24358009 pmcid: 3865839
Kotarać M, Radovanović N, Lekić N et al (2015) Surgical treatment of median arcuate ligament syndrome: case report and review of literature. Srp Arh Celok Lek 143:1–2. https://doi.org/10.2298/sarh1502074k
doi: 10.2298/sarh1502074k
Dabit JY, Valenzuela-Almada MO, Vallejo-Ramos S et al (2021) Epidemiology of antiphospholipid syndrome in the general population. Curr Rheumatol Rep 23:85. https://doi.org/10.1007/s11926-021-01038-2
doi: 10.1007/s11926-021-01038-2
Miyakis S, Lockshin MD, Atsumi T et al (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome(APS). J Thromb Haemost 4(2):295–306. https://doi.org/10.1111/j.1538-7836.2006.01753.x
doi: 10.1111/j.1538-7836.2006.01753.x pubmed: 16420554
Aringer M, Costenbader K, Daikh D (2019) European league against rheumatism/American college of rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis 78(9):1151–1159. https://doi.org/10.1136/annrheumdis-2018-214819
doi: 10.1136/annrheumdis-2018-214819 pubmed: 31383717
Pandiaraja J, Sathyaseelan A (2016) Budd-Chiari syndrome as an initial manifestation of systemic lupus erythematosus. J Clin Diagn Res. https://doi.org/10.7860/JCDR/2016/16623.7532
doi: 10.7860/JCDR/2016/16623.7532 pubmed: 27190864 pmcid: 4866162
Bint A, Ata F, Abdelrazek M et al (2021) Budd-Chiari syndrome on background of JAK2V617F mutation with no hematologic abnormalities. Clin Case Rep. https://doi.org/10.1002/ccr3.4668
doi: 10.1002/ccr3.4668
Reshetnyak TM, Seredavkina NV, Reshetnyak VI (2015) Liver transplantation in a patient with primary antiphospholipid syndrome and Budd-Chiari syndrome. World J of Hepatol 7(19):2229–2236. https://doi.org/10.4254/wjh.v7.i19.2229
doi: 10.4254/wjh.v7.i19.2229
Cacciapaglia F, Vadacca M, Coppolino G et al (2007) Spontaneous splenorenal shunt in a patient with antiphospholipid syndrome: the first case reported. Lupus 6(1):56–58. https://doi.org/10.1177/0961203306072390
doi: 10.1177/0961203306072390
Ferral H, Behrens G, Lopera J (2012) Budd-Chiari syndrome. Am J Roentgenol 199(4):737–745. https://doi.org/10.2214/AJR.12.9098
doi: 10.2214/AJR.12.9098
Abdel Hameed MR, Sadek Elbeih A-MS, Abd El-Aziz MH (2020) Epidemiological characteristics and etiology of budd-chiari syndrome in upper Egypt. J Blood Med 11:515–524. https://doi.org/10.2147/JBM.S278678
doi: 10.2147/JBM.S278678 pubmed: 33408545 pmcid: 7779296
Ezzahi M, Zaid E, Farid A (2023) Budd-Chiari syndrome secondary to retro-hepatic vena cava web: an unusual cause of epigastric pain. Radiol Case Rep 18(3):1088–1092. https://doi.org/10.1016/j.radcr.2022.12.044
doi: 10.1016/j.radcr.2022.12.044 pubmed: 36684614 pmcid: 9849858
Rosenthal E, Sangle SR, Taylor P et al (2006) Treatment of mesenteric angina with prolonged anticoagulation in a patient with antiphospholipid (Hughes) syndrome and coeliac artery stenosis. Ann Rheum Dis 65:1398–1399. https://doi.org/10.1136/ard.2005.050344
doi: 10.1136/ard.2005.050344 pubmed: 16973790 pmcid: 1798319
Shirish RS, Wajanat J, Hosam E et al (2022) Abdominal arterial lesions associated with antiphospholipid antibodies: a comparative crosssectional magnetic resonance angiography study. Rheumatology (Oxford) 61(2):658–666. https://doi.org/10.1093/rheumatology/keab400
doi: 10.1093/rheumatology/keab400
Uthman I, Khamashta M (2007) The abdominal manifestations of the antiphospholipid syndrome. Rheumatology 46:1641–1647. https://doi.org/10.1093/rheumatology/kem158
doi: 10.1093/rheumatology/kem158 pubmed: 17636180
Li S, Fan Y, Tian G et al (2022) Feasible management of median arcuate ligament syndrome in orthotopic liver transplantation recipients. World J Gastrointest Surg 14(9):976–985. https://doi.org/10.4240/wjgs.v14.i9.976
doi: 10.4240/wjgs.v14.i9.976 pubmed: 36185558 pmcid: 9521469
Sun X, Fan Z, Qiu W (2018) Median arcuate ligament syndrome and arterial anastomotic bleeding inducing hepatic artery thrombosis after liver transplantation. Medicine (Baltimore) 97(25):10947. https://doi.org/10.1097/MD.0000000000010947
doi: 10.1097/MD.0000000000010947
Gruber H, Loizides A, Peer S et al (2012) Ultrasound of the median arcuate ligament syndrome: a new approach to diagnosis. Med Ultrason 14(1):5–9
pubmed: 22396932
Bansal V, Gupta P, Sarojh S et al (2018) Budd-Chiari syndrome: imaging review. Br J Radiol 91(1092):20180441. https://doi.org/10.1259/bjr.20180441
doi: 10.1259/bjr.20180441 pubmed: 30004805 pmcid: 6319835
Petri M (2022) Antiphospholipid syndrome. Transl Res 225:70–81. https://doi.org/10.1016/j.trsl.2020.04.006
doi: 10.1016/j.trsl.2020.04.006
Dufrost V, Risse J, Reshetnyak T et al (2018) Increased risk of thrombosis in antiphospholipid syndrome patients treated with direct oral anticoagulants. Results from an international patient-level data meta-analysis. Autoimmun Rev 17(10):1011–1021. https://doi.org/10.1016/j.autrev.2018.04.009
doi: 10.1016/j.autrev.2018.04.009 pubmed: 30103045
Arachchillage DR, Pericleous C (2023) Evolution of antiphospholipid syndrome. Semin Thromb Hemost 49(03):295–304. https://doi.org/10.1055/s-0042-1760333
doi: 10.1055/s-0042-1760333 pubmed: 36646109
Youkhana K, Heiling H, Deal A et al (2023) The effect of rituximab on antiphospholipid titers in patients with antiphospholipid syndrome. Th Open 07(03):191–194. https://doi.org/10.1055/s-0043-1770784
doi: 10.1055/s-0043-1770784
Tripodi A, Scalambrino E, Clerici M et al (2023) Laboratory diagnosis of antiphospholipid syndrome in anticoagulated patients. Biomedicines. https://doi.org/10.3390/biomedicines11061760
doi: 10.3390/biomedicines11061760 pubmed: 37371855 pmcid: 10296059
Ruff WE, Vieira SM, Kriegel MA (2015) The role of the gut microbiota in the pathogenesis of antiphospholipid syndrome. Curr Rheumatol Rep 17(1):472. https://doi.org/10.1007/s11926-014-0472-1
doi: 10.1007/s11926-014-0472-1 pubmed: 25475595 pmcid: 4394866
Michele M, Kosiewicz AL, Zirnheld PA (2011) Gut microbiota, immunity and disease: a complex relationship. Front cell infect microbiol. https://doi.org/10.3389/fmicb.2011.00180
doi: 10.3389/fmicb.2011.00180

Auteurs

Paulina Janiak (P)

Department of Rheumatology, Hospital in Kościerzyna, Kościerzyna, Poland. janiak.paulinaa@gmail.com.

Żaneta Smoleńska (Ż)

Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland. zaneta.smolenska@gumed.edu.pl.

Monika Skotarczak (M)

Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland.

Zbigniew Zdrojewski (Z)

Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Classifications MeSH