Work

Concomitant pulmonary embolism and severe thrombocytopenia associated with an APS-like autoimmune thrombophilic condition: a case report

Year: 2026

Type: article

Abstract: Severe thrombocytopenia accompanied by acute pulmonary embolism (PE) represents a rare and challenging clinical scenario, particularly in elderly patients, where both thrombotic and hemorrhagic risks coexist.We report the case of a 78-year-old man who presented with acute dizziness and was found to have severe thrombocytopenia (platelet count 32 × 10⁹/L) and objectively confirmed pulmonary embolism. Given the high bleeding risk, prophylactic-dose low-molecular-weight heparin was initiated. Shortly thereafter, the patient developed intracerebral hemorrhage, prompting immediate discontinuation of anticoagulation.Extensive evaluation excluded heparin-induced thrombocytopenia, thrombotic microangiopathy, malignancy, and infection. Autoimmune testing revealed persistent isolated positivity for anti–β2-glycoprotein I IgM antibodies, suggesting an APS-like autoimmune thrombophilic state, although high-specificity classification criteria for antiphospholipid syndrome were not fully met.Notably, both thrombocytopenia and pulmonary embolism gradually improved without further anticoagulation. At follow-up, no recurrent thrombosis occurred.This case highlights the diagnostic uncertainty and therapeutic complexity of managing venous thromboembolism in the setting of severe thrombocytopenia and APS-spectrum autoimmunity.

Source: BMC Pulmonary Medicine

DOI: 10.1186/s12890-026-04146-w

Authors: Zhongshan Yang, Hanbin Lin, Yuxiong Hu, Ying Zhang, Qingyu Lin, Maohe Chen

Institution: Putian University

Language: English

Topic: Systemic Lupus Erythematosus Research

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090