Morbidity of lupus anticoagulants in children: a single institution experience.
BACKGROUND
The lupus anticoagulant (LA) and the anticardiolipin antibodies (ACA) are the antiphospholipid antibodies more relevant clinically. Their clinical manifestations are diverse with most patients being asymptomatic while others present venous or arterial thrombosis, and more rarely, bleeding. Our objectives were to evaluate clinical presentation of LA in children and to correlate it to LA behavior.


METHODS
A retrospective cohort of patients (under 18 years old) who had a positive determination of LA followed by at least another determination of LA at a variable period was evaluated. Personal and family history, including infectious diseases temporally related to the event, were recorded. The screening of other coagulation disorders was performed according to symptoms, family history or laboratory results.


RESULTS
Thirty-six patients were evaluated, median age was 10.8 years old, and 52.8% were female. Asymptomatic patients were 19.4% (7/36) of study population. Bleeding and thrombosis were found in 52.8% and 27.8%, respectively. Median LA determinations per patient were 3. von Willebrand disease was diagnosed in 66.7% of patients consulting for bleeding. A concomitant hemostatic defect was found in 8/10 patients with thrombosis (p = 0.003). LA behavior was not uniform and not correlated to symptoms.


CONCLUSIONS
Most LA found in children is incidental and asymptomatic. In children with bleeding, LA might be a fortuitous finding associated with VWD. The persistence of LA does not imply a higher risk of thrombosis.
Casais
Patricia
P
Thrombosis and Hemostasis Department, Institute of Hematological Research, National Academy of Medicine, Pacheco de Melo 3081, Buenos Aires 1425, Argentina. casais@hemtologia.anm.edu.ar
Meschengieser
Susana S
SS
Gennari
Laura C
LC
Alberto
Maria F
MF
Sanchez-Luceros
Analia
A
Blanco
Alicia N
AN
Lazzari
Maria A
MA
D000293:Adolescent; D001778:Blood Coagulation Disorders / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D008297:Male; D009017:Morbidity; D012189:Retrospective Studies; D013927:Thrombosis / Q000453:epidemiology; D014842:von Willebrand Diseases / Q000453:epidemiology
D016682:Lupus Coagulation Inhibitor