Double trouble: myocardial infarction with non-obstructive coronary arteries as a presentation of Hughes syndrome in monozygotic twins

Lupus. 2020 Apr;29(5):505-508. doi: 10.1177/0961203320906267. Epub 2020 Feb 10.

Abstract

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a recently described, clinically significant entity, with prevalence rates ranging from 1% to 14% and a mean of 6% of all patients with myocardial infarction. Antiphospholipid syndrome (APS; Hughes syndrome) is characterized by the presence of antiphospholipid antibodies associated with thrombosis (arterial and/or venous) and/or pregnancy morbidity and could be the cause of MINOCA. Data on genetic predisposition to APS are scarce. The present study describes a unique case of monozygotic twin brothers who, at a young age, developed the same clinical presentation of APS. The diagnosis of APS was later confirmed, along with a diagnosis of systemic lupus erythematosus in one brother.

Keywords: Antiphospholipid syndrome; MINOCA; systemic lupus erythematosus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Antiphospholipid / immunology
  • Antiphospholipid Syndrome / complications
  • Antiphospholipid Syndrome / diagnosis*
  • Coronary Artery Disease / etiology*
  • Coronary Artery Disease / pathology
  • Humans
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / diagnosis*
  • Male
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / pathology
  • Twins, Monozygotic*

Substances

  • Antibodies, Antiphospholipid