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[Antiphospholipid antibody syndrome as a possible cause of paresis in a child]
Insights
A pediatric case of left hemiplegia in a 4-year-old boy was linked to cerebral vessel thrombosis and anti-phospholipid antibodies. Routine antibody testing is suggested for thrombotic events.
Area of Science:
- Neurology
- Pediatrics
- Vascular Medicine
Background:
- A 4-year-old boy presented with acute left hemiplegia.
- Initial brain CT was negative, but subsequent imaging revealed focal lesions.
Observation:
- Cerebral angiography identified thrombosis of a perforating vessel and cerebral artery hypoplasia.
- Low IgG positivity for anti-cardiolipin antibodies was detected.
Findings:
- The neurological symptoms resolved within two months.
- The case suggests a link between anti-phospholipid antibodies and cerebral thrombosis in pediatric patients.
Implications:
- This case highlights the importance of considering anti-phospholipid antibodies in pediatric thrombotic events.
- Routine assessment of anti-phospholipid antibodies is recommended for patients with unexplained thrombosis.
Abstract:
The Authors report on the case of a 4-year-old boy, admitted to the pediatric department for left hemiplegia. CT scan of the brain was negative on the day of admission but, on the following day, showed 3 small hypodense focal lesions in the posterior branch of the internal capsule, in the knee of the internal capsule and in the posterior parietal region of the cortex. The acute phase almost completely resolved in 10 days. Twenty days after presentation, cerebral angiography showed a thrombosis of an anterior, right perforating vessel, together with the hypoplasia of the horizontal portion of the cerebral anterior artery. The determination of anti-cardiolipin antibodies, even though performed far from the acute phase of the disease, showed a low IgG positivity. Two months after the onset the neurological symptoms completely resolved. In the presence of hypoplasia, narrowing and other lesions of cerebral vessel, it is possible to hypotesize that the occurrence of thrombotic fenomen, ascribable to anti-phaspholipid antibodies, is responsible for the neurological symptoms. The association of thrombosis and anti-phospholipid antibodies suggest that the assessment of anti-phospholipid antibodies should be routinely performed in the presence of thrombotic phenomena.