The autoantibodies are present in 50% of patients with SLE and 1-5% of the general population. The antiphospholipid antibodies are found in serum in 1% of healthy persons and 3% of older age group (2). Though APS can involve any age group, the target group is young to middle aged adults. Depending upon the site of vascular obstruction, various symptoms occur in patients with APS. Interference in the balance between procoagulant and anticoagulant factors and disruption of the clotting mechanism by the antiphospholipid antibodies (APLA) lead to leg ulcers, toe gangrene, myocardial infarction, purpura, stroke, recurrent miscarriage or preterm births.

Eosinophilic granulomatosis polyangiitis represents less than 2% of vasculitis cases in childhood. Children have worse long-term outcomes and higher mortality. Cardiac involvement portends a worse prognosis. We describe here an adolescent girl who presented with heart failure and stroke. Her blood investigations showed eosinophilia and high IgE levels. Cardiac evaluation revealed myocarditis, intracardiac thrombus, and endomyocardial fibrosis, a rare presentation of this disease in childhood.