Long-term treatment of antiphospholipid syndrome-associated cerebral arterial thromboses with intravenous immunoglobulin: a case report.
We report a now 13-year-old male with trisomy 21, hypothyroidism, and insulin-dependent diabetes who developed acute hemiplegia due to the antiphospholipid antibody syndrome (APS) at age four. The risks of long-term anticoagulation were initially considered to be high; hence, he was treated with monthly infusions of intravenous immunoglobulin (IVIG) at 2 g/kg for 2 years and then every other month for 7 years. Antiphospholipid antibodies were no longer detectable within 6 months and have continued to be negative. There was no clinical deterioration or further changes on magnetic resonance arteriography over 7 years. IVIG may be an alternative therapeutic choice for children with APS who are not candidates for conventional anticoagulation.
Arabshahi
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B
Section of Rheumatology, St. Christopher's Hospital for Children/Drexel University College of Medicine, Philadelphia, PA, USA. arabshahi@email.chop.edu
Thompson
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ED
Smergel
E M
EM
Goldsmith
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DP
D000293:Adolescent; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002536:Cerebral Arteries / Q000187:drug effects* / Q000473:pathology; D004314:Down Syndrome / Q000150:complications / Q000473:pathology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous