Thrombotic Recurrence Under New Oral Anticoagulants Revealing Antiphospholipid Antibody Syndrome: Case Report

Introduction and importance: Non-vitamin K antagonist Oral Anti-Coagulants (NOACs) have emerged as an effective treatment for thromboembolic events with a reduced bleeding risk compared to traditional anti-vitamin K drugs. However, their role in managing antiphospholipid antibody syndrome remains a subject of debate. Case presentation: We present the case of a 48-year-old man with a history of pulmonary embolism and a right cavitary thrombus, who was receiving treatment with a new-generation anticoagulant. Despite this treatment, he exhibited resistance, prompting further investigation that led to the diagnosis of antiphospholipid antibody syndrome. Clinical discussion: Our clinical case highlights the importance of routinely screening for antiphospholipid syndrome, especially when it coexists with lupus, due to the potential ineffectiveness of NOACs. Conclusion: This case underscores the necessity of considering alternative treatment strategies in individuals with antiphospholipid antibody syndrome, particularly when traditional anticoagulants prove inadequate, even when lupus is concurrent.