Mycoplasma pneumonia with antiphospholipid antibodies and a cardiac thrombus

Abstract

A case is reported of a four-year old child with mycoplasma pueumonia with a left atrial thrombus secondary to aPL antibodies. He was anticoagulated and the thrombus resolved in six months.

Antiphospholipid antibodies in response to infection

“…M. pneumoniae is a major cause of respiratory infections in school-aged children and young adults and also has been associated with the presence of aPL, particularly in patients with severe infection and in patients with high titer of cold hemagglutinins [40]. Recently, M. pneumoniae infection was reported in several pediatric cases with thrombotic events secondary to aPL, including cardiac thrombus, internal carotid artery occlusion, and two cases with splenic infarcts [41,42].…”

Thrombosis and antiphospholipid antibody syndrome during acute Q fever

“…[8] During acute Q fever, IgG aCL are more frequent than lupus anticoagulant and IgM anticardiolipin antibodies, whereas anti-β2glycoprotein I antibodies are very rare. [3,9] However, “infectious” aCL, which are generally β2-glycoproetin I independent, were believed to be found in conditions not involving thrombotic complications, [7] whereas antiphospholipid-associated thrombosis during infections has been reported with Mycoplasma pneumoniae, [10–13] Bacteroides, [14] EBV, [15] CMV, [16,17] HIV, [18,19] HBV, [20] and HCV. [21] …”

Mycoplasma pneumonia and pulmonary embolism in a child due to acquired prothrombotic factors

“…There are five previous reports in the literature of M. pneumoniae infection in children associated with thromboembolic episodes, one of these associated with a familial antithrombin deficiency. [2][3][4][5][6] A recent Swedish study of 128 children admitted with a first episode of venous thromboembolism showed 54% to have a combination of risk factors for venous thrombosis. 7 The presence of acquired activated protein C resistance with anti-phospholipid antibodies has been reported previously, and is attributed to B2-glycoprotein 1 and anti-prothrombin antibodies.…”

“…There are five previous case reports associating infection with M. pneumoniae with the development of thromboembolism. [2][3][4][5][6] The mechanism by which Mycoplasma infections can cause thrombosis may be multifactorial, including the development of autoantibodies.…”