A Case of Infantile De Novo Primary Antiphospholipid Syndrome Revealed by a Neonatal Arterial Ischemic Stroke

Merlin, Étienne; Doré, Éric; Chabrier, Stéphane; Biard, M.; Marquès-Verdier, Alain

doi:10.1177/0883073811435238

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…For example, in one case of a 3-day old infant with perinatal ischemic stroke, aCL was detected at high titers. 57 However, the infant did not experience thrombotic recurrence thereafter.…”

Section: Anticardiolipin Antibodymentioning

confidence: 86%

“…So far, few studies have assessed the impact of long term anticoagulation or antiplatelet on the risk of cerebral arterial thrombosis complications and recurrence. While the use of aspirin can lead to the prevention of recurrent events and a neurological recovery in some patients, 57 other patients with same type of aPL positivity had recurrence and neurological deficits on follow-up. 13 Based on few case reports, neonates who used low-molecular-weight heparin (LMWH) in combination with aspirin did not have neurological complications upon follow-up.…”

Section: Managementmentioning

confidence: 99%

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

Hasbani

Taher

Sunji

et al. 2021

Lupus

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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.

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“…For example, in one case of a 3-day old infant with perinatal ischemic stroke, aCL was detected at high titers. 57 However, the infant did not experience thrombotic recurrence thereafter.…”

Section: Anticardiolipin Antibodymentioning

confidence: 86%

Section: Managementmentioning

confidence: 99%

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

Hasbani

Taher

Sunji

et al. 2021

Lupus

View full text Add to dashboard Cite

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“…At the present time, it is still unclear whether outcomes for de novo and transmitted neonatal APS are different, and whether the de novo APS may precede other autoimmune diseases, such as systemic lupus erythematosus (26)(27)(28)(29)(30)(31)(32)(33)(34).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Infantile Ischemic Stroke and Antiphospholipid Antibodies, Description of Four Cases

et al. 2020

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Antiphospholipid syndrome (APS) is a rare condition in childhood, but even more in the neonatal age. Most neonatal cases are considered a passively acquired autoimmune disease, due to a transplacental passage of maternal antiphospholipid antibodies (aPL) from mothers with primary or secondary APS or, more often, from asymptomatic aPL carriers. Exceedingly unusual is the neonatal de novo production of aPL. We present four infants with presumed perinatal stroke in presence of increased and persistent aPL levels, even after 6 months of life, opening the window on a gray zone related to the origin of these antibodies (maternal or neonatal) and on their role in the pathogenesis of stroke.

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“…We observed that 43% of the patients in this study had seizures as a major clinical manifestation and that these were usually secondary to cerebral artery infarcts. Thus, epilepsy development was unusual [10, 11, 14–17, 20, 21]. Alshekaili et al [17] described the case of a 5-day-old newborn who had a reduction in spontaneous right limb movements.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Laboratory, and Therapeutic Analyses of 21 Patients with Neonatal Thrombosis and Antiphospholipid Antibodies: A Literature Review

Peixoto

Carvalho²,

Rodrigues

2014

Journal of Immunology Research

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Objectives. A review of the literature reports neonatal thrombosis and antiphospholipid antibodies cases through a retrospective study that focuses on the pathogenesis and main clinical and laboratory manifestations of this disease. Methods. The case reports were selected from PubMed. The keywords used to search were neonatal, antiphospholipid syndrome, thrombosis, and antiphospholipid antibodies. References that were published from 1987 to 2013 were reviewed. Results. Twenty-one cases of neonatal thrombosis and antiphospholipid antibodies were identified. Ten children were born preterm (before 37 weeks). Arterial involvement (17/21) was predominant, of which stroke (12/17) was the most prevalent clinical manifestation. Anti-cardiolipin antibodies were predominant (13/21) in the antiphospholipid antibody profiles. Treatments were based on the use of symptomatics such as antiepileptics (8/21), and 6/21 patients received heparin. There were 4 deaths (4/21); otherwise, the children recovered well, especially the neonates who suffered from strokes (9/12). Conclusion. Neonatal thrombosis and antiphospholipid antibodies are rare. The development of thrombotic manifestations in neonates seems not to be associated exclusively with the aPL, but their etiology may be linked to pre- and perinatal events. We noted good therapeutic responses, especially in stroke patients, who presented with favorable outcomes in 82% of the cases.

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A Case of Infantile De Novo Primary Antiphospholipid Syndrome Revealed by a Neonatal Arterial Ischemic Stroke

Cited by 9 publications

References 8 publications

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

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

Case Report: Infantile Ischemic Stroke and Antiphospholipid Antibodies, Description of Four Cases

Clinical, Laboratory, and Therapeutic Analyses of 21 Patients with Neonatal Thrombosis and Antiphospholipid Antibodies: A Literature Review

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