{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T11:10:10Z","timestamp":1744888210329,"version":"3.40.4"},"reference-count":12,"publisher":"Scientific Scholar","content-domain":{"domain":["nmji.in"],"crossmark-restriction":true},"short-container-title":["NMJI"],"abstract":"<jats:p>Antiphospholipid antibody syndrome (APS) is characterized by vascular thrombosis. Somewhat paradoxically, some patients with this disease develop diffuse alveolar haemorrhage. This bleeding is usually a delayed manifestation, occurring a few years after the onset of other manifestations and diagnosis of APS. We encountered a patient with an unusual presentation, i.e. onset with diffuse alveolar haemorrhage as well as vascular thromboses. He also had autoimmune haemolytic anaemia, which is infrequent in APS. The diagnosis of APS was based on elevated levels of IgM and IgG anti-cardiolipin antibody and IgG and IgM beta-2 GP1 antibodies. Treatment with high-dose glucocorticoids, anticoagulants and rituximab led to a decline in levels of these antibodies and was associated with a good and lasting clinical response.<\/jats:p>","DOI":"10.25259\/nmji_616_21","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T10:42:04Z","timestamp":1744886524000},"page":"329-331","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antiphospholipid anti-body syndrome presenting with diffuse alveolar haemorrhage and refractory autoimmune haemolytic anaemia"],"prefix":"10.25259","volume":"37","author":[{"given":"VIKAS","family":"MARWAH","sequence":"first","affiliation":[{"name":"Department of Pulmonary, Critical Care and Sleep Medicine, Army Institute of Cardiothoracic Sciences, Armed Forces Medical College, Wanowrie, Pune 411040, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ARUN","family":"HEGDE","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology Command Hospital, Southern Command, Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SUDIPT","family":"ADHIKARI","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care and Sleep Medicine, Army Institute of Cardiothoracic Sciences, Armed Forces Medical College, Wanowrie, Pune 411040, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ROBIN","family":"CHOUDHARY","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care and Sleep Medicine, Army Institute of Cardiothoracic Sciences, Armed Forces Medical College, Wanowrie, Pune 411040, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"10.25259\/NMJI_616_21\/ref-1","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/j.1538-7836.2006.01753.x","article-title":"International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS)","volume":"4","author":"Miyakis","year":"2006","journal-title":"J Thromb Haemost"},{"key":"10.25259\/NMJI_616_21\/ref-2","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1002\/acr.22109","article-title":"Primary antiphospholipid syndrome-associated diffuse alveolar hemorrhage","volume":"66","author":"Cartin-Ceba","year":"2014","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"10.25259\/NMJI_616_21\/ref-3","doi-asserted-by":"publisher","first-page":"2029","DOI":"10.2169\/internalmedicine.54.4058","article-title":"Primary antiphospholipid syndrome associated with diffuse alveolar hemorrhage and pulmonary thromboembolism","volume":"54","author":"Isshiki","year":"2015","journal-title":"Intern Med"},{"key":"10.25259\/NMJI_616_21\/ref-4","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.ccm.2010.05.005","article-title":"Pulmonary manifestations of the antiphospholipid antibody syndrome","volume":"31","author":"Ford","year":"2010","journal-title":"Clin Chest Med"},{"key":"10.25259\/NMJI_616_21\/ref-5","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.semarthrit.2005.05.006","article-title":"Antiphospholipid antibodies as a cause of pulmonary capillaritis and diffuse alveolar hemorrhage: A case series and literature review","volume":"35","author":"Deane","year":"2005","journal-title":"Semin Arthritis Rheum"},{"key":"10.25259\/NMJI_616_21\/ref-6","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1016\/j.semarthrit.2014.10.013","article-title":"Antiphospholipid antibodies-associated diffuse alveolar hemorrhage","volume":"44","author":"Yachoui","year":"2015","journal-title":"Semin Arthritis Rheum"},{"key":"10.25259\/NMJI_616_21\/ref-7","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1084\/jem.200116116","article-title":"Complement C3 activation is required for antiphospholipid antibody-induced fetal loss","volume":"195","author":"Holers","year":"2002","journal-title":"J Exp Med"},{"key":"10.25259\/NMJI_616_21\/ref-8","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1038\/nm1121","article-title":"Heparin prevents antiphospholipid antibody-induced fetal loss by inhibiting complement activation","volume":"10","author":"Girardi","year":"2004","journal-title":"Nat Med"},{"key":"10.25259\/NMJI_616_21\/ref-9","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.autrev.2018.10.002","article-title":"Mechanisms of action and historical facts on the use of intravenous immunoglobulins in systemic lupus erythematosus","volume":"18","author":"Mart\u00ednez","year":"2019","journal-title":"Autoimmun Rev"},{"key":"10.25259\/NMJI_616_21\/ref-10","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s40164-020-00163-5","article-title":"Efficacy and safety of rituximab in autoimmune and microangiopathic hemolytic anemia: A systematic review and meta-analysis","volume":"9","author":"Chao","year":"2020","journal-title":"Exp Hematol Oncol"},{"key":"10.25259\/NMJI_616_21\/ref-11","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1177\/0961203311422713","article-title":"Rituximab induces resolution of recurrent diffuse alveolar hemorrhage in a patient with primary antiphospholipid antibody syndrome","volume":"21","author":"Scheiman Elazary","year":"2012","journal-title":"Lupus"},{"key":"10.25259\/NMJI_616_21\/ref-12","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1111\/bjh.12541","article-title":"A phase III randomized trial comparing glucocorticoid monotherapy versus glucocorticoid and rituximab in patients with autoimmune haemolytic anaemia","volume":"163","author":"Birgens","year":"2013","journal-title":"Br J Haematol"}],"container-title":["The National Medical Journal of India"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/nmji.in\/antiphospholipid-anti-body-syndrome-presenting-with-diffuse-alveolar-haemorrhage-and-refractory-autoimmune-haemolytic-anaemia\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/nmji.in\/antiphospholipid-anti-body-syndrome-presenting-with-diffuse-alveolar-haemorrhage-and-refractory-autoimmune-haemolytic-anaemia\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T10:42:05Z","timestamp":1744886525000},"score":1,"resource":{"primary":{"URL":"https:\/\/nmji.in\/antiphospholipid-anti-body-syndrome-presenting-with-diffuse-alveolar-haemorrhage-and-refractory-autoimmune-haemolytic-anaemia\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,16]]},"references-count":12,"alternative-id":["10.25259\/NMJI_616_21"],"URL":"https:\/\/doi.org\/10.25259\/nmji_616_21","relation":{},"ISSN":["2583-150X","0970-258X"],"issn-type":[{"value":"2583-150X","type":"electronic"},{"value":"0970-258X","type":"print"}],"subject":[],"published":{"date-parts":[[2025,4,16]]},"article-number":"329"}}