title: Clinical and laboratory characteristics of children positive for antiphospholipid antibodies.
abstract: BACKGROUND
  It is difficult to estimate the actual prevalence of antiphospholipid syndrome (APS) in the paediatric population since there are no standardised criteria. We aimed to assess clinical and laboratory characteristics of a cohort of children positive for antiphospholipid antibodies (aPL) to contribute to the understanding of the heterogeneous aPL-related features in childhood.
  
  
  METHODS
  Forty-four patients with prolonged activated partial thromboplastin time were enrolled and assigned to group I ("transiently positive") or group II ("persistently positive"), based on the detection of elevated aPL plasma levels [lupus anticoagulant (LA), anticardiolipin (aCL), and anti-β2-glycoprotein I (anti-β2GPI) antibodies] on, respectively, one or more occasions, at least 12 weeks apart, by standard procedures. The clinical history and symptoms of all patients were recorded.
  
  
  RESULTS
  Thirty-three (75%) patients were assigned to group I, while the other 11 (25%) formed group II. Major associated diseases in group I were urticarial vasculitis (21%), acute infections (18%) and thalassaemia (12%). Five subjects (15%) were asymptomatic. Four out of the 11 subjects (36%) in group II had thrombotic events; they were all persistently aPL-positive and two of them had concomitant systemic lupus erythematosus. The rate of detection of LA-positivity was not significantly different between the two groups (76% vs 91%, p>0.05), whereas the percentage of patients positive for overall aCL was higher in group II than in group I (54% vs 42%, respectively; p<0.05). Specifically, aCL IgG and anti-β2GPI IgM subtypes were significantly more represented in group II than in group I (100% vs 62% and 75% vs 33%, respectively; p<0.05).
  
  
  CONCLUSIONS
  Our study shows that aPL-positive children have different features that should be taken into account in the classification of criteria for paediatric APS.
authors.affiliation: Department of Biomedicine of Developmental Age, University of Bari, Bari, Italy. giordano@bioetaev.uniba.it
authors.forename: Paola
authors.initials: P
authors.lastname: Giordano
authors.forename: Riccardina
authors.initials: R
authors.lastname: Tesse
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lassandro
authors.forename: Deborah
authors.initials: D
authors.lastname: Fracchiolla
authors.forename: Prudenza
authors.initials: P
authors.lastname: Ranieri
authors.forename: Antonella
authors.initials: A
authors.lastname: Lotito
authors.forename: Domenico
authors.initials: D
authors.lastname: De Mattia
authors.forename: Giovanni Carlo
authors.initials: GC
authors.lastname: Del Vecchio
mesh_terms: D000293:Adolescent; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010314:Partial Thromboplastin Time / Q000379:methods; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D017152:Antibodies, Antiphospholipid