ArticleFrontiers in immunology2026
Case Report: Recurrent coronary in-stent restenosis as the primary manifestation of non-criteria antiphospholipid syndrome confirmed by anti-phosphatidylserine/prothrombin IgM antibodies.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: A 47-year-old female with no traditional CAD risk factors developed recurrent in-stent restenosis (ISR) one year after LAD stenting. She had recurrent pregnancy loss, chronic urticaria, anemia, and proteinuria, with negative conventional antiphospholipid antibodies. Case: After second stenting, aPS/PT IgM was elevated (51.65 U/mL), supporting the diagnosis of non-criteria APS. Thromboelastography (TEG) showed decreased R time, increased MA and CI, suggestive of a hypercoagulable state. Warfarin (INR 2-3) and hydroxychloroquine (200 mg bid) plus DAPT led to no chest pain recurrence and stent patency at 21-month follow-up. Conclusions: Recurrent ISR without traditional risk factors should raise suspicion for non-criteria APS. A moderately elevated aPS/PT IgM may serve as a diagnostic clue. Anticoagulation plus immunomodulation may help prevent further thrombotic events.
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