Antiphospholipid syndrome in a neonate

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Immunology

Background:

• Antiphospholipid syndrome (APS) involves recurrent thrombosis and/or pregnancy morbidity.
• Maternal antiphospholipid antibodies can passively transfer to neonates, potentially increasing thrombotic risk.
• Neonatal presentation of APS with severe complications like arterial thrombosis is exceptionally rare.

Observation:

• A 10-day-old neonate presented with Klebsiella sepsis and arterial gangrene of the left lower limb.
• Diagnostic workup revealed thrombosis of the left femoral artery.
• Both the mother and the neonate tested positive for antiphospholipid antibodies.

Findings:

• The neonate's condition was attributed to the passive transfer of antiphospholipid antibodies from the mother.
• The presence of Klebsiella sepsis acted as a significant secondary risk factor for thrombosis.
• This case underscores the potential for severe thrombotic events in neonates exposed to antiphospholipid antibodies.

Implications:

• Highlights the importance of considering antiphospholipid syndrome in neonates with unexplained thrombosis, especially with a maternal history.
• Emphasizes the critical role of secondary risk factors (e.g., infection) in precipitating thrombotic complications in antibody-exposed neonates.
• Suggests the need for vigilant monitoring and prompt management of neonates born to mothers with antiphospholipid syndrome to prevent severe outcomes.