Clinical significance of lupus anticoagulants in children  

Oleh:

Male, Christoph ; Lechner, Klaus ; Eichinger, Sabine ; Kyrle, Paul A. ; Kapiotis, Stylianos

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Pediatrics vol. 135 no. 02 (Feb. 1999), page 199-205.
Topik: ACA ; Anti-cardiolipin antibodies; ANA ; Antinuclear antibodies; Anti-dsDNA ; Anti-double-stranded DNA antibodies; APA ; Anti-phospholipid antibodies; APS ; Anti-phospholipid antibody syndrome; APTT ; Activated partial thromboplastin time; DRVVT ; Dilute Russell’s viper venom time; LA ; Lupus anticoagulants; SLE ; Systemic lupus erythematosus

Ketersediaan

Perpustakaan FK Nomor Panggil: J45.K.1999.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objectives: To determine the spectrum of associated clinical manifestations and time course of lupus anticoagulants (LA) in children. Study design: Retrospective study of 95 consecutive children (46 boys and 47 girls), with a median age of 5.3 years (range, 1.7 to 17.1 years), diagnosed with presence of LA at a hemostasis referral center; 83 were followed up over a median of 2.9 years (range, 6 weeks to 21.6 years). Results: At diagnosis, 80 of 95 (84%) children were free of symptoms, and presence of LA was found incidentally. Nine children (10%) had bleeding symptoms, 5 (5%) had thrombotic events, and 1 had systemic lupus erythematosus. Among the patients with bleeding, 5 had transient severe hypoprothrombinemia after adenovirus infections, and 3 had thrombocytopenia. None of the children who were initially free of symptoms had bleeding, thrombotic complications, or autoimmune disease subsequently. At follow-up, 48 of 83 (58%) patients had normal activated partial thromboplastin time values after 1.9 years (5 weeks to 19.1 years). Thirty-two (38%) still had activated partial thromboplastin time elevations but did not fulfill all criteria for presence of LA after 3.2 years (7.4 months to 9.3 years). Three (4%) patients, who had presented with thrombosis, had persistent positive LA, anti-cardiolipin, and antinuclear antibodies after 1.4, 2.8, and 7.5 years, respectively. One of these had recurrent thrombosis. Conclusions: In most children the presence of LA did not lead to clinical complications and was transient. Bleeding occurred with additional hypoprothrombinemia or thrombocytopenia. Thrombosis was rare and strongly associated with persistently positive LA.

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