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[Renal arterial thrombosis and the antiphospholipid antibody syndrome: a case report]

C S Macedo1, R S Martinez, M C Riyuzo

  • 1Universidade Estadual Paulista, SP, Brazil.

Jornal De Pediatria
|December 4, 2003
PubMed

Insights

Antiphospholipid antibody syndrome can cause arterial thrombosis in children, even without other autoimmune diseases. Early investigation is crucial for diagnosis and management of this rare condition.

Area of Science:

  • Pediatric Nephrology
  • Rheumatology
  • Vascular Medicine

Background:

  • Antiphospholipid syndrome (APS) is a rare autoimmune disorder.
  • It can manifest with arterial thrombosis in children, often presenting with renal complications.
  • This case highlights the importance of considering APS in pediatric arterial thrombosis.

Purpose of the Study:

  • To report an unusual case of antiphospholipid syndrome in a young child.
  • To describe the clinical presentation, diagnostic challenges, and management of APS-related renal thrombosis.
  • To emphasize the need for investigating APS in children with arterial thrombosis.

Main Methods:

  • Case report of a 2-year-old child with renal failure and thrombosis.
  • Diagnostic workup included laboratory tests, peritoneal dialysis, renal biopsy, Doppler ultrasonography, and arteriography.
  • Treatment involved nephrectomy and antihypertensive drugs; later, anticardiolipin antibody testing was performed.

Main Results:

  • The child presented with severe renal failure, hypertension, and right renal artery occlusion.
  • Renal biopsy confirmed infarction; arteriography showed complete occlusion.
  • Despite initial treatment, seizures occurred, and anticardiolipin antibodies were positive, confirming APS.
  • The child is now asymptomatic with normalized antibodies after follow-up.

Conclusions:

  • Pediatric arterial thrombosis warrants investigation for antiphospholipid antibody syndrome, even if collagen diseases are absent.
  • Early diagnosis and management of APS are critical for preventing severe complications like renal infarction.
  • This case underscores the diverse clinical manifestations of APS in children.

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