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Published on: October 25, 2018
Recent advances in antiphospholipid antibodies and antiphospholipid syndromes in pediatric populations
1Department of Pediatrics, University Medical Center Ljubljana, Slovenia.
Insights
Antiphospholipid antibodies (aPL) are increasingly found in children, but thrombotic events are rare. Infections often cause transient aPL, requiring careful clinical judgment in pediatric autoimmune and non-autoimmune diseases.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Autoimmune Diseases
Background:
- Antiphospholipid antibodies (aPL) and their clinical significance are increasingly recognized in pediatric autoimmune and non-autoimmune diseases.
- Pathogenic mechanisms of pediatric antiphospholipid syndrome (APS) are similar to adults, but clinical manifestations differ.
- Pediatric patients lack adult prothrombotic risk factors, leading to a lower frequency of aPL-related thrombotic events.
Purpose of the Study:
- To review recent data on the prevalence and clinical significance of aPL in pediatric populations.
- To highlight differences in aPL presentation between children and adults.
- To discuss the role of infections in transient aPL in childhood.
Main Methods:
- Literature review of recent studies on aPL in neonates, children, and adolescents.
- Analysis of data on prevalence, clinical features, and pathogenic mechanisms.
- Comparison of pediatric and adult aPL findings.
Main Results:
- The frequency of aPL-related thrombotic events is generally low in pediatric populations.
- Acquired infections are frequently responsible for non-pathogenic and transient aPL in childhood.
- Clinical judgment of elevated aPL in children requires consideration of these unique factors.
Conclusions:
- While pathogenic mechanisms are similar, the clinical spectrum of aPL differs between pediatric and adult populations.
- Transient and non-pathogenic aPL are common in children, often linked to infections.
- Careful evaluation is necessary when interpreting aPL results in pediatric patients.
Abstract:
In recent years, antiphospholipid antibodies (aPL) and their associated clinical features have been recognized increasingly in various pediatric autoimmune and non-autoimmune diseases. Pathogenic mechanisms involved in pediatric antiphospholipid syndrome (APS) appear to be the same as in adults. However, since pediatric patients do not have prothrombotic risk factors present in adults, there clearly are differences in the spectrum of clinical findings. The frequency of aPL-related thrombotic events is generally low in pediatric populations. On the other hand, various commonly acquired infections are likely to be responsible for higher percentage of non-pathogenic and transient aPL in childhood. Such points have to be considered in clinical judgment of elevated aPL in children. In this review we summarize the recent data on the prevalence and clinical significance of aPL in neonates, children and adolescents.
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