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Case report of male child with elevated lipoprotein (a) leading to acute ischemic stroke

Patrick M Moriarty1,2, Heather Tennant1,2, Nandhini Sehar1,2

  • 1Division of Clinical Pharmacology, University of Kansas Medical Center, Kansas City, Kansas, USA.

Journal of Clinical Apheresis
|February 1, 2017
PubMed

Insights

Elevated Lipoprotein (a) [Lp(a)] is a rare cause of childhood stroke. Treatment with lipoprotein apheresis (LA) successfully prevented further events in an 11-year-old boy with multiple thrombotic strokes.

Area of Science:

  • Pediatric Neurology
  • Cardiovascular Science
  • Thrombosis Research

Background:

  • Acute ischemic stroke (AIS) in children is uncommon, with a significant proportion remaining cryptogenic.
  • Elevated Lipoprotein (a) [Lp(a)] is an emerging risk factor for cerebrovascular events.
  • Understanding rare causes of pediatric AIS is crucial for timely diagnosis and treatment.

Observation:

  • An 11-year-old boy presented with multiple thrombotic strokes.
  • Extensive investigation revealed elevated Lp(a) as the sole identified risk factor.
  • The patient's clinical presentation indicated a link between high Lp(a) and recurrent stroke events.

Findings:

  • Lipoprotein apheresis (LA) was initiated as a targeted therapy for the elevated Lp(a).
  • The patient received continuous LA treatment for 18 months post-stroke.
  • No further cerebrovascular events occurred during the treatment period.

Implications:

  • This case highlights Lp(a) as a treatable cause of cryptogenic AIS in children.
  • Lipoprotein apheresis demonstrates efficacy in managing high Lp(a) and preventing recurrent strokes.
  • Further research into Lp(a) screening and apheresis in pediatric populations is warranted.

Keywords:
acute ischemic strokelipoprotein (a)lipoprotein apheresismultiple thrombotic strokespediatric stroke

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