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Babies, Blood Clots, Biology

Michael D. Lockshin, MD

JAMA. 1997;277(19):1549-1551.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CASE PRESENTATION

At the age of 22 years, a Hispanic woman developed joint pain, fatigue, rash, and thrombocytopenia. Results of antinuclear and anti-DNA antibody tests were positive. Urinalysis and renal function test results were normal. Systemic lupus erythematosus (SLE) was diagnosed, and hydroxychloroquine sulfate and nonsteroidal anti-inflammatory drugs were prescribed. She did well until she was seen again at age 29 years, when she developed scotomata following a first-trimester spontaneous abortion. Findings of a neurological evaluation, including magnetic resonance imaging, electroencephalography, and Doppler studies, were unremarkable. At age 30 years, severe intrauterine growth restriction, hypertension, and proteinuria complicated a pregnancy, which ended with fetal death at 22 weeks.

At age 32 years, the patient sought another opinion. This examination revealed normal vital signs, slight patches of malar erythema, lupus rash, livedo reticularis (Figure), and a loud apical systolic murmur. Her platelet count was 96X10⁹/L. Prothrombin time was 13.0 . . . [Full Text PDF of this Article]

Author Affiliations
From the Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Md. Dr Lockshin is now with the Barbara Volcker Center for Women and Rheumatic Disease, The Hospital for Special Surgery-Cornell Medical Center, New York, NY.

Footnotes
Corresponding author: Michael D. Lockshin, MD, Barbara Volcker Center for Women and Rheumatic Disease, The Hospital for Special Surgery-Cornell Medical Center, 535 E 70th St, New York, NY 10021 (e-mail: LockshinM@hss.edu).

Grand Rounds at the Clinical Center of the National Institutes of Health section editors: John I. Gallin, MD, the Clinical Center of the National Institutes of Health, Bethesda, Md; David S. Cooper, MD, Contributing Editor, JAMA.

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