Prevalence and Resolution of Lupus Anticoagulant in Children.
BACKGROUND
Lupus anticoagulant (LA) is an autoantibody that inhibits phospholipid-dependent reactions. Studies on the incidence and prevalence of LA in the pediatric population are lacking. The objective of our study was to determine the incidence and potential risk of complications of LA in children presenting with abnormal partial thromboplastin time (PTT). Our secondary objective was to identify signs, symptoms, and medical history associated with the presence of LA as documented in the literature. We focused on the correlation between signs of LA in the form of laboratory values consistent with bleeding abnormalities and the presence of clinical symptoms of bleeding.


METHODS
We conducted a record-based retrospective analysis of 112 children and adolescents referred to the Department of Hematology/Oncology at Children's Hospital of New Orleans for abnormal coagulation profiles and/or history of mucocutaneous bleeding. Participants were followed up until PTT values normalized.


RESULTS
In our study population with suspected bleeding disorder, the preliminary incidence of LA was 21%. We found that resolution of LA correlated with correction of PTT in 90% of patients.


CONCLUSIONS
To minimize extensive and expensive blood workup, we recommend that screening for LA be included in the evaluation of children with prolonged PTT, even if they have a negative history of bleeding problems.
Department of Hematology/Oncology, Louisiana State University Health Sciences Center/Children's Hospital, New Orleans, LA.
Chandra
C
Kallanagowdar
Department of Pediatrics, Louisiana State University Health Services Center/Children's Hospital, New Orleans, LA.
Aman
A
Chauhan
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Mora V
MV
Puertolas
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA ; Department of Pediatric Hematology/Oncology, Ochsner Clinic Foundation, New Orleans, LA.
Rajasekharan
R
Warrier
Antibodies–anticardiolipin; lupus coagulation inhibitor; lupus erythematosus–systemic; pediatrics