title: Recurrent arterial and venous thrombosis in a 16-year-old boy in the course of primary antiphospholipid syndrome despite treatment with low-molecular-weight heparin: a case report.
abstract: BACKGROUND
  Antiphospholipid syndrome is a multisystem autoimmune disease characterized by arterial and/or venous thrombosis and persistent presence of antiphospholipid antibodies. It can be a primary disease or secondary when associated with other autoimmune diseases.
  
  
  METHODS
  We present a case of a 16-year-old Caucasian boy with a massive arterial and venous thrombosis in his lower limbs as well as in his central nervous system with clinical symptoms such as headaches and chorea. He did not present any clinical or laboratory signs of a systemic inflammatory connective tissue disease, including systemic lupus erythematosus. Based on the clinical picture and results of the diagnostic tests (positive antibodies against β2-glycoprotein and a high titre of anticardiolipin antibodies) we finally diagnosed primary antiphospholipid syndrome. During a 9-month follow up after the acute phase of the disease, he was treated with low-molecular-weight heparin. Neurological symptoms were relieved. Features of recanalization in the vessels of his lower limbs were observed. After a subsequent 6 months, because of the failure of preventive treatment - an incident of thrombosis of the vessels of his testis - treatment was modified and heparin was replaced with warfarin.
  
  
  CONCLUSIONS
  Although the preventive treatment with warfarin in our patient has continued for 1 year of follow up without new symptoms, further observation is needed.
authors: Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, 36/50 Sporna St,, 91-738, Lodz, Poland. e.smolewska@wp.pl.
authors: Malgorzata
authors: M
authors: Biernacka-Zielinska
authors: Joanna
authors: J
authors: Lipinska
authors: Joanna
authors: J
authors: Szymanska-Kaluza
authors: Jerzy
authors: J
authors: Stanczyk
authors: Elzbieta
authors: E
authors: Smolewska
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