The varicella-autoantibody syndrome

Area of Science:

• Immunology
• Pediatrics
• Hematology

Background:

• Varicella zoster virus (VZV) infection can be associated with thrombotic complications.
• The role of autoantibodies in VZV-associated thrombosis requires further investigation.

Purpose of the Study:

• To determine the incidence of autoantibodies to phospholipids and coagulation proteins in children with acute VZV infection.
• To investigate the association between these autoantibodies and thrombotic complications in children with VZV.

Main Methods:

• Cross-sectional study comparing VZV-infected children (with and without complications) to a control group.
• Assay for free protein S (PS), protein C, antithrombin, prothrombin, associated antibodies, lupus anticoagulant, anticardiolipin antibody, antiphospholipid antibodies, and prothrombin fragment 1+2.
• Data on coinfections were collected.

Main Results:

• VZV-infected children showed increased frequency of lupus anticoagulant, anticardiolipin antibody, antiphospholipid antibodies, and autoantibodies to PS, protein C, prothrombin, and antithrombin compared to controls.
• Children with VZV and purpura fulminans/thromboembolism had decreased free PS, increased PS IgG antibody, and increased prothrombin fragment 1+2.
• Elevated PS IgG antibody correlated negatively with free PS and positively with prothrombin fragment 1+2; autoantibodies were transient.

Conclusions:

• Transient antiphospholipid and coagulation protein autoantibodies are common in children with VZV infection.
• These autoantibodies are not predictive of thrombotic complications.
• Further research may explore the mechanisms linking VZV infection to autoantibody production.