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Managing antiphospholipid antibodies and antiphospholipid syndrome in children

Anil V Kamat1, David P D'Cruz, Beverley J Hunt

  • 1Department of Haematology, Guys' & St Thomas' Foundation Trust London SE1 7EH, UK.

Haematologica
|December 6, 2006
PubMed

Insights

Pediatric antiphospholipid antibodies (aPL) can be transient after infections or indicate antiphospholipid syndrome (APS). Management of thrombotic events in children with APS is challenging due to limited evidence.

Area of Science:

  • Pediatric Rheumatology
  • Immunology
  • Hematology

Background:

  • Antiphospholipid antibodies (aPL) and antiphospholipid syndrome (APS) are increasingly diagnosed in pediatric populations.
  • Transient, non-pathogenic aPL are common post-infection, contrasting with rarer thrombotic events in children with true aPL.

Purpose of the Study:

  • To review the clinical scenarios of children with aPL, including asymptomatic aPL, primary APS, and secondary APS.
  • To discuss the manifestations and management strategies for childhood aPL and APS, supported by case histories.

Main Methods:

  • Review of clinical scenarios and case histories related to pediatric aPL and APS.
  • Discussion of current understanding and challenges in managing childhood aPL and APS.

Main Results:

  • Thrombotic events in children with true aPL present significant management challenges.
  • Limited evidence-based medicine exists for managing pediatric aPL and APS, particularly regarding anticoagulation.

Conclusions:

  • Management of pediatric aPL and APS requires further investigation, especially concerning anticoagulation safety and efficacy.
  • Multicenter randomized controlled trials are needed to address unresolved issues in the treatment of childhood aPL and APS.

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