Asherson Ronald A, D'Cruz David
Division of Immunology, School of Pathology, University of the Witwatersrand, Johannesburg 2000, South Africa.
Clin Rheumatol. 2007 Sep;26(9):1531-3. doi: 10.1007/s10067-006-0417-9. Epub 2006 Nov 25.
A 61-year-old female with a history of previous digital ischemia and stroke, developed bilateral brachial artery thromboses thought originally to be due to fibromuscular hyperplasia. Histology from one artery revealed bland thrombi only with no evidence of vasculitis. Minimal elevations of anti-B2GP1 were demonstrated with levels of other isotypes measurable at just below cut off levels for normality. Three months later, she developed carcinoma of the breast, which required surgical treatment followed by chemotherapy. Three years later, all aPl determinations were negative with levels well below the cutoff levels for all isotypes. The minimal anti-B2GP1 elevation may have been triggered by the vascular damage caused by the thromboses or may perhaps have been pathogenic in the causation of these thromboses. An alternative explanation is that the antibodies may have presaged the development of the malignancy. To favour any one of these explanations remains highly speculative.
一名61岁女性，有既往指端缺血和中风病史，发生双侧肱动脉血栓形成，最初认为是由于纤维肌增生所致。一条动脉的组织学检查仅显示单纯性血栓，无血管炎证据。抗β2糖蛋白1有轻微升高，其他同种型水平仅略低于正常临界值。三个月后，她患了乳腺癌，需要手术治疗，随后进行化疗。三年后，所有抗磷脂抗体检测均为阴性，所有同种型水平均远低于临界值。抗β2糖蛋白1的轻微升高可能是由血栓形成引起的血管损伤触发的，也可能在这些血栓形成的病因中具有致病性。另一种解释是，这些抗体可能预示了恶性肿瘤的发生。支持这些解释中的任何一种都仍然极具推测性。
