Hepatitis-A Infection-Induced Secondary Antiphospholipid Syndrome With Neuro-ophthalmological Manifestations

Antiphospholipid syndrome (APS) is a multisystem autoimmune disorder that can affect children and adults alike, with a similar spectrum of thrombotic events, predominately deep vein thrombosis and stroke. It is characterized by recurrent arterial or venous thrombosis and recurrent fetal loss with the presence of antiphospholipid antibodies (aPL) like antibodies to beta-2-glycoprotein I (B-2-GPI) and anticardiolipin (aCL). The disease could be classified into primary APS in the absence of an underlying disease or secondary APS occurring secondary to autoimmune diseases, infections, malignancies, and sometimes medication use. In the absence of clinical manifestations of APS, transient non-thrombogenic antiphospholipid antibodies are seen more commonly in children, predominantly after childhood infections. Cases with clinical manifestations of APS associated with different types of infections have been reported in the literature to keep track of potential triggering causes and take measures to prevent or treat the disease manifestations. This case documents the case of hepatitis-A as a triggering viral infection, causing secondary APS in a child.