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Lupus anticoagulants in children
Michael Briones1, Thomas Abshire
1Div. Hematology, Oncology, BMT, Emory University School of Medicine, AFLAC Cancer Center and Blood Disorder Service Children's Healthcare of Atlanta, 2040 Ridgewood Drive, Suite 100, Atlanta, GA 30322, USA. michael.briones@oz.ped.emory.edu
Current Opinion in Hematology
|August 13, 2003
Summary
Lupus anticoagulant and antiphospholipid antibodies (ACAs) increase thrombosis risk. In children, these antibodies can indicate serious conditions if symptomatic, but may be transient in asymptomatic cases.
Area of Science:
- Immunology
- Hematology
- Pediatrics
Background:
- Lupus anticoagulant and antiphospholipid antibodies (ACAs) are heterogeneous IgG and IgM antibodies.
- These antibodies prolong in vitro clotting times.
- They are linked to thrombosis, fetal loss, and autoimmune cytopenias.
Purpose of the Study:
- To describe the clinical significance of lupus anticoagulant and ACAs in children.
- To compare pediatric and adult presentations of antiphospholipid antibody syndrome (APS).
- To evaluate the prognosis of isolated lupus anticoagulant and ACAs in children.
Main Methods:
- Review of clinical presentations and laboratory results of pediatric patients.
- Analysis of thrombosis risk, fetal loss, and autoimmune conditions.
- Comparison of outcomes between symptomatic and asymptomatic children.
Main Results:
- Children with thrombosis and positive lupus anticoagulant/ACAs show similar clinical features and prognoses to adults.
- Antiphospholipid antibodies target phospholipid-binding proteins like beta2-glycoprotein and prothrombin.
- Isolated lupus anticoagulant and ACAs in asymptomatic children are likely transient and benign.
Conclusions:
- Antiphospholipid antibody syndrome in children shares clinical and prognostic similarities with adults.
- The presence of lupus anticoagulant and ACAs in symptomatic children warrants clinical attention.
- Asymptomatic children with isolated lupus anticoagulant and ACAs generally have a favorable prognosis.