Clinical significance of lupus anticoagulants in children☆,☆☆
Section snippets
Patients
Ninety-five consecutive children, 47 girls and 48 boys, in whom LA had been identified at our hemostasis referral center between 1969 and 1996, were studied. Median age at diagnosis of presence of LA was 5.3 years (range, 1.7 to 17.1 years). Most patients had been followed up at variable intervals after diagnosis. Eighty-three patients could be studied longitudinally, having had at least one follow-up examination (mean, 2; range, 1 to 5). Only patients who were followed up for more than 6
Clinical Symptoms at Diagnosis of Presence of LA
Eighty of 95 (84%) children were free of symptoms, and presence of LA was diagnosed incidentally. In most cases (n = 69) coagulation tests had been done for preoperative screening, mainly before planned adenotonsillectomy (n = 54). Only 15 patients (16%) had specific symptoms leading to the diagnosis of presence of LA: 9 (10%) patients were referred because of bleeding symptoms (Table I). Five of these had bleeding symptoms of acute onset associated with severe hypoprothrombinemia, 3 had mild
DISCUSSION
Our study provides evidence that the presence of LA does not lead to clinically relevant complications and is transient in most children. LA were found incidentally in 84% of our children; 68% were identified at screening before adenotonsillectomy, representing a selected population with recurrent sinus, tonsillar, and upper respiratory tract infections. A relationship between bacterial or viral infections and LA in these children has previously been suggested.21, 24, 27, 28 Our series had an
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Cited by (126)
Diagnosis and treatment of antiphospholipid syndrome in childhood: A review
2017, Blood Cells, Molecules, and DiseasesPaediatric Antiphospholipid Syndrome
2017, Handbook of Systemic Autoimmune DiseasesCitation Excerpt :The frequency of anti-β2GPI in healthy children ranges from 3% to 7%, and high levels of anti-β2GPI seem to be relatively more frequent in preschool children than in adolescents and healthy adults [42,43]. LA have also been described in apparently healthy children and are usually found incidentally in preoperative coagulation screening as prolonged activated partial thromboplastin time [44]. The risk of future thrombosis is low in otherwise healthy children who were incidentally found to have positive aPL, but it is prudent to perform a follow-up determination after a time interval of at least 12 weeks.
Pediatric Antiphospholipid Syndrome
2016, Handbook of Systemic Autoimmune DiseasesCitation Excerpt :The optimal management of adolescents with aPL also should include the avoidance of smoking and use of oral contraceptives. Asymptomatic children, in whom aPL were incidentally found, only rarely develop thrombotic complications [7]. Because of the low thrombosis risk, it is generally assumed that these children do not need any prophylactic treatment.
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Reprint requests: Christoph Male, MD, Department of Paediatrics, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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