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Antiphospholipid syndrome — SCE Rheumatology MCQ

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HardConnective tissue diseasesAntiphospholipid syndromeSCE Rheumatology

A patient has livedo racemosa, repeated transient ischaemic attacks and severe hypertension. Renal biopsy shows fibrous intimal hyperplasia and recanalised thrombi without vasculitis. Which APS manifestation is most likely?

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Correct answer: E — Antiphospholipid-associated thrombotic microangiopathy

APS nephropathy is a thrombotic microangiopathy characterised by acute or chronic small-vessel lesions, hypertension and renal dysfunction. Histology shows thrombosis and chronic vascular remodelling rather than inflammatory destruction of the vessel wall.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions