Antiphospholipid antibodies and cerebrovascular thrombosis in the pediatric population: Few answers to many questions.

Abstract

Most of the knowledge in pediatric antiphospholipid syndrome (APS) is derived from studies performed on the adult population. As in adults, antiphospholipid antibodies (aPL) can contribute to thrombosis, especially cerebrovascular thrombosis, in neonates and children. Since aPL have the potential to cross the placental barrier, and since the pediatric population is prone to infections, re-testing for their positivity is essential to specify their role in cerebrovascular thrombosis.In this review, we aimed at assessing the prevalence of aPL, criteria or non-criteria, in neonatal and childhood ischemic stroke and sinovenous thrombosis trying to find an association between aPL and cerebrovascular thrombosis in the neonatal and pediatric population. Also, we looked into the effect of aPL and anticoagulants/antiplatelets on the long term neurological outcomes of affected neonates or children. The questions regarding the prevalence of aPL among pediatric patients with cerebrovascular thrombosis, the relationship between the titers of aPL and incidence and recurrence of cerebrovascular events, the predictability of the long term neurological outcomes, and the most optimal anticoagulation plan are still to be answered. However, it is crucial for clinicians to screen neonates and children with cerebrovascular thrombosis for aPL and confirm their presence if positive.

• Authors: Georges El Hasbani, Ali T Taher, Nadine Sunji, Savino Sciascia, Imad Uthman
• Journal: Lupus (Lupus) Vol. 30 Issue 9 Pg. 1365-1377 (Aug 2021) ISSN: 1477-0962 [Electronic] England
• PMID: 34082580 (Publication Type: Journal Article, Review)

Chemical References

• Antibodies, Anticardiolipin
• Antibodies, Antiphospholipid
• Anticoagulants
• Lupus Coagulation Inhibitor
• Platelet Aggregation Inhibitors

Topics

• Adult
• Antibodies, Anticardiolipin (adverse effects, blood)
• Antibodies, Antiphospholipid (adverse effects, blood)
• Anticoagulants (therapeutic use)
• Antiphospholipid Syndrome (blood, diagnosis, drug therapy, etiology)
• Child
• Female
• Humans
• Infant, Newborn
• Intracranial Thrombosis (blood, drug therapy, etiology)
• Ischemic Stroke (blood, etiology)
• Lupus Coagulation Inhibitor (adverse effects, blood)
• Lupus Erythematosus, Systemic (blood, complications)
• Platelet Aggregation Inhibitors (therapeutic use)
• Pregnancy
• Sinus Thrombosis, Intracranial (blood, etiology)