Upper extremity venous thrombosis associated with primary antiphospholipid syndrome and immunoglobulin M nephropathy in diabetes mellitus type II

Abstract

Antiphospholipid syndrome (APS) is a disorder characterized by antiphospholipid antibody positivity,arterial or venous thrombosis, and fetal loss. In APS, renal as well as vascular and glomerular involve-ment is observed. Systemic lupus erythematosus and other connective tissue diseases should beexcluded to diagnose primary APS. Immunoglobulin M (IgM) nephropathy is characterized by singleor dominant IgM deposition in glomerular mesangium. It often presents with hematuria and pro-teinuria. In a 45-year-old female patient admitted to our clinic with diabetes mellitus and proteinuria,fundus examination did not reveal diabetic retinopathy but a high anticardiolipin IgM and venousthrombosis in the upper extremity were observed. Renal biopsy revealed IgM nephropathy. The pa-tient was diagnosed with primary APS and IgM nephropathy. Cyclophosphamide and steroid treat-ment was started. Her proteinuria decreased as a result of the treatment. Although, it is reported inthe literature that primary APS coexists with other glomerulonephritis, we did not detect coexistenceof primary APS and IgM nephropathy.