title: Central retinal vein occlusion in a pediatric patient with SLE and antiphospholipid antibodies without anti-cardiolipin or anti-β2 glycoprotein I antibodies.
abstract: BACKGROUND
  Antiphospholipid antibody syndrome is characterized by venous and/or arterial thrombosis, and is found in patients with systemic lupus erythematosus. Its diagnosis requires the presence of both clinical and laboratory findings, such as positive anti-cardiolipin and anti-β2 glycoprotein I antibodies and lupus anticoagulant. However, cardiolipin is a minor component of the vascular endothelial cells in human, and phosphatidylcholine and phosphatidylethanolamine are major components.
  
  
  METHODS
  A 15-year-old female suddenly developed massive left intraretinal hemorrhaging due to central retinal vein occlusion. She also had a butterfly rash, and her laboratory findings revealed positive serum anti-nuclear antibodies and decreased serum complement. During this episode, she was diagnosed with systemic lupus erythematosus. Although she was negative for serum anti-cardiolipin IgG and anti-β2 glycoprotein I antibodies as well as lupus anticoagulant, her serum anti-phosphatidylcholine, anti-phosphatidylethanolamine, anti-phosphatidylinositol and phosphatidylserine IgG antibodies levels were increased.
  
  
  CONCLUSIONS
  Pediatric cases of central retinal vein occlusion are rare. Even in patients without anti-cardiolipin or anti-β2 glycoprotein I antibodies and lupus anticoagulant, there is the potential for the development of antiphospholipid antibody-related thrombosis.
authors.affiliation: Department of Pediatrics and Child Neurology, Oita University Faculty of Medicine, Hasama, Yufu, Oita 879-5593, Japan. kseigo@oita-u.ac.jp.
authors.forename: Seigo
authors.initials: S
authors.lastname: Korematsu
authors.forename: Hironori
authors.initials: H
authors.lastname: Goto
authors.forename: Chika
authors.initials: C
authors.lastname: Gotoh
authors.forename: Ryoko
authors.initials: R
authors.lastname: Ohki
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kubota
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Izumi
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D010713:Phosphatidylcholines / Q000276:immunology; D010714:Phosphatidylethanolamines / Q000276:immunology; D010716:Phosphatidylinositols / Q000276:immunology; D010718:Phosphatidylserines / Q000276:immunology; D012166:Retinal Hemorrhage / Q000209:etiology; D012170:Retinal Vein Occlusion / Q000209:etiology*
chemical_list: D000906:Antibodies; D017152:Antibodies, Antiphospholipid; D007074:Immunoglobulin G; D010713:Phosphatidylcholines; D010714:Phosphatidylethanolamines; D010716:Phosphatidylinositols; D010718:Phosphatidylserines; C483858:phosphatidylethanolamine