To the Editor: The patient with possible systemic lupus erythematosus described in the March 2 Clinical Problem-Solving article1 most likely had primary or secondary antiphospholipid-antibody syndrome.2,3 She had documented thrombi in both legs, along with an unexplained elevation in partial-thromboplastin time and a positive test for lupus anticoagulant. These serologic abnormalities, and occasionally a decrease in platelet count, are characteristic of antiphospholipid-antibody syndrome. A test for anticardiolipin antibodies was apparently not done. The antiphospholipid-antibody syndrome occurs in up to one third of patients with systemic lupus.3 The presence of anticardiolipin antibodies would be consistent with this patient's clinical picture.Â .Â .
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