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Antiphospholipid antibodies in Turkish children with thrombosis
Betul Tavil1, Emel Ozyurek, Fatma Gumruk
1Hacettepe University Faculty of Medicine, Pediatric Hematology Unit, 06100 Sihhiye, Ankara, Turkey.
Insights
Antiphospholipid antibodies (APA) were found in 11.6% of Turkish children with thrombosis. Testing for APA is recommended in pediatric thrombosis cases, particularly those with arterial clots.
Area of Science:
- Pediatric Thrombosis
- Autoimmune Disorders
- Hematology
Background:
- Antiphospholipid syndrome (APS) is a systemic autoimmune disorder.
- APS is characterized by thrombosis, thrombocytopenia, and fetal loss.
- The role of antiphospholipid antibodies (APA) in pediatric thrombosis in Turkey is not well-defined.
Purpose of the Study:
- To determine the frequency of APA positivity in Turkish children with thrombosis.
- To identify associated prothrombotic risk factors other than APA.
- To evaluate the outcomes in children with APA and thrombosis.
Main Methods:
- A cohort of 138 children presenting with thrombosis was evaluated.
- Antiphospholipid antibodies (APA) were tested.
- Other prothrombotic risk factors were assessed.
Main Results:
- APA positivity was observed in 11.6% (16/138) of the children.
- The majority of APA-positive children (68.8%) had multiple additional prothrombotic risk factors.
- Arterial thrombosis was the most common presentation (62.5%) among APA-positive children.
Conclusions:
- APA testing should be considered for all children diagnosed with thrombosis.
- Particular attention should be given to children with arterial thrombosis.
- The presence of multiple risk factors alongside APA may influence outcomes in pediatric APS.
Abstract:
Antiphospholipid syndrome is a systemic disorder characterized by arterial and/or venous thrombosis, thrombocytopenia, recurrent fetal loss, and presence of antiphospholipid antibodies (APA). The importance of APA in Turkish children with thrombosis is unknown. This study aimed to evaluate the frequency of APA positivity, associated risk factors other than APA, and outcome in children with APA and thrombosis. The presence of APA was investigated in 138 children presenting for evaluation of thrombosis; other prothrombotic risk factors were also studied. The frequency of APA positivity among 138 children was 11.6% (16/138). The mean age of these 16 children (10 female, 62.5%) was 9.57 +/- 4.59 years (range, 2.5-18.0 years). The mean follow-up period was 31.7 +/- 21.7 months (range, 5-60 months). Recurrence was observed during follow-up in two patients (12.5%). Ten patients (62.5%) had arterial thrombosis, five patients (31.3%) venous thrombosis, and one patient (6.3%) purpura fulminans. Among the thrombotic children with APA, 11 (68.8%) had more than one prothrombotic risk factor other than circulating APA [five patients (31.3%) had two risk factors, two patients (12.5%) had three, and four patients (25.0%) had four]. Five patients (31.3%) had no additional risk factors. APA should be tested in all children with thrombosis, especially those with arterial thrombosis.
