Antiphospholipid antibody syndrome in a six-year-old female patient.

Abstract

PURPOSE:

To report the first instance of primary antiphospholipid antibody (APA) syndrome in an otherwise healthy 6-year-old female patient with retinal venous thromboses.

DESIGN:

Observational case report.

METHODS:

A 6-year-old girl with poor vision in the left eye and preretinal hemorrhage underwent testing for infectious, autoimmune and embolic disease, diabetes, and hypertension. Testing for factor V Leiden and prothrombin G20210A mutations, homocysteine, anticardiolipin antibodies (ACAs), lupus anticoagulant, and functional assays for protein S, protein C, and antithrombin III were performed to detect a hypercoagulable state. No IRB approval was necessary.

RESULTS:

Only a positive lupus anticoagulant and moderately elevated ACA IgG were found. The ACA IgG was moderately elevated on repeat testing 18 months later. Laser to nonperfused retina caused some regression of retinal neovascularization. Aspirin was recommended to reduce the risk of future thromboses.

CONCLUSIONS:

Although uncommon, retinovascular thrombosis in children can occur in APA syndrome. Testing for ACA and lupus anticoagulant should be considered.

• Authors: M Elizabeth Hartnett, Michael Laposata, Elizabeth Van Cott
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 135 Issue 4 Pg. 542-4 (Apr 2003) ISSN: 0002-9394 [Print] United States
• PMID: 12654376 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Antibodies, Anticardiolipin
• Antibodies, Antiphospholipid
• Lupus Coagulation Inhibitor
• factor V Leiden
• Homocysteine
• Factor V
• Prothrombin
• Aspirin

Topics

• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antibodies, Anticardiolipin (blood)
• Antibodies, Antiphospholipid (blood)
• Antiphospholipid Syndrome (complications, diagnosis, drug therapy)
• Aspirin (therapeutic use)
• Child
• Factor V (genetics)
• Female
• Fluorescein Angiography
• Homocysteine (blood)
• Humans
• Lupus Coagulation Inhibitor (blood)
• Mutation
• Prothrombin (genetics)
• Retinal Hemorrhage (etiology)
• Retinal Vein (pathology)
• Retinal Vein Occlusion (diagnosis, drug therapy, etiology)
• Visual Acuity