Primary anti-phospholipid antibody syndrome caused by isolated anti-phosphatidylethanolamine antibodies presenting as cryptogenic fibrosing alveolitis with recurrent pulmonary hemorrhage after single-lung transplantation.

A 28-year-old man underwent a single-lung transplantation for rapidly progressive usual interstitial pneumonitis. Following transplantation, primary anti-phospholipid antibody syndrome was diagnosed after a thromboembolic event and continued dyspnea. Review of his native lung and allograft tissue showed diffuse hemorrhage secondary to capillary injury, probably reflecting anti-phospholipid antibody effects on endothelia.