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Antiphospholipid antibody syndrome manifested as a postoperative cerebrovascular event in a child
1Department of Child Health, University of Missouri, Columbia 65212, USA.
Insights
Pediatric perioperative stroke is rare. A 6-year-old boy developed hemiparesis post-surgery, potentially due to an anticardiolipin antibody indicating a hypercoagulable state.
Area of Science:
- Pediatric Neurology
- Vascular Surgery
- Hematology
Background:
- Perioperative cerebrovascular events are rare in children.
- Potential causes include emboli, sickle cell disease, vascular anomalies, vasculitis, and prothrombotic states.
Observation:
- A 6-year-old boy experienced right-sided hemiparesis on postoperative day 2.
- This occurred after a patch angioplasty for renal artery stenosis.
Findings:
- Workup suggested a hypercoagulable state.
- An anticardiolipin antibody was identified as a potential cause.
Implications:
- This case highlights the importance of considering hypercoagulable states in pediatric post-operative stroke.
- Anticardiolipin antibody syndrome may present atypically in children.
- Further review of anticardiolipin antibody syndrome pathogenesis, diagnosis, and treatment is warranted.
Abstract:
Perioperative cerebrovascular events are exceedingly uncommon in pediatric patients. The etiology of such problems includes emboli from intracardiac thrombi, sickle cell disease, vascular anomalies, vasculitis affecting the cerebral vasculature, and prothrombotic states. We describe a 6-year-old boy who had right-sided hemiparesis on the second postoperative day after an uneventful patch angioplasty for renal artery stenosis. Workup revealed a possible hypercoagulable state due to an anticardiolipin antibody. The pathogenesis of the anticardiolipin antibody syndrome, its clinical manifestations, diagnostic criteria, and potential treatment strategies are reviewed.