Primary antiphospholipid syndrome: a unique presentation with multiple visceral aneurysms

We present a unique case of a young woman with a proven primary type of antiphospholipid syndrome (APS) and multiple abdominal visceral aneurysms. Only one other case with such an association has been reported before to our knowledge. The presence of visceral aneurysms poses a therapeutic challenge because the anticoagulation treatment may be catastrophic in view of the risk of aneurysm rupture and abdominal bleeding. A 38 year old woman was transferred from the department of obstetrics and gynaecology of the hospital, because of peripheral oedema. Two days earlier she had had a third trimester pregnancy loss. She had a history of four unexplained deaths of morphologically normal fetuses at the third trimester, during the past 10 years. She was the mother of a healthy 7 year old child. A diagnosis of primary APS was made based on clinical and serological criteria. Anticardiolipin IgG antibodies were present at a moderate level (48 GPL units; normal