Open AccessDigital ischaemia secondary to adalimumab-induced antiphospholipid syndrome
Author(s) -
Shashank Cheemalavagu,
Sara S. McCoy,
Jason S. Knight
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-232907
Subject(s) - medicine , adalimumab , antiphospholipid syndrome , warfarin , aspirin , vitamin k antagonist , thrombosis , rheumatology , lupus anticoagulant , surgery , gastroenterology , disease , atrial fibrillation
A 50-year-old woman with a history of Crohn's disease treated with adalimumab presented with left hand pain and duskiness. Angiogram showed non-filling of the radial and digital arteries of the hand. Antiphospholipid antibody testing was positive, leading to a diagnosis of antitumour necrosis factor-induced antiphospholipid syndrome. Adalimumab was discontinued, and she was treated with the vitamin K antagonist warfarin and low-dose aspirin. Upon resolution of the antiphospholipid antibodies, she was transitioned to aspirin alone without recurrence of thrombosis.