Antiphospholipid syndrome presenting as dilated cardiomyopathy in an 11-year-old boy

We report on an 11-year-old Omani boy who presented with acute heart failure due to dilated cardiomyopathy. Examination revealed the presence of left ventricular thrombi on echocardiography and a marked elevation of anticardiolipin antibodies. Subsequently the boy exhibited features of antiphospholipid syndrome including multiple thrombotic episodes involving the brain, and renal and iliac veins. We could not document any underlying cause of the antiphospholipid syndrome. His cardiac status subsequently deteriorated and he expired from multiorgan failure. Resistant heart failure from dilated cardiomyopathy secondary to primary antiphospholipid syndrome is uncommon and has not been reported in children.