Pulmonary embolism and transitory anti-b2-GPI antibodies in an adult with chicken pox

Abstract

Anti-beta2-glycoprotein I antibodies are considered as a specific marker for the antiphospholipid syndrome. In contrast to lupus circulating anticoagulant and anticardiolipin (aCL) antibodies, they are usually not found at significant levels in infections. We report a case of pulmonary embolism in an adult with varicella. Transient significant levels of aCL antibodies and of IgM anti-beta2-GPI antibodies were observed. No other prothrombotic factor, including free protein S antigen deficiency, was found. The direct pathogenic role of these transient antibodies on the thrombotic event may then be suspected. They are probably associated with VZV acute infection and are absent two months after varicella.

Purpura fulminans in a Child as a Complication of Chickenpox Infection

“…The absence of any protein S increase after receiving fresh frozen plasma, the return to normal levels of protein S 1 month after infection as well as the parents’ normal protein S values, all indicate that protein S deficiency was acquired and caused by anti-protein-S antibodies. Moreover, antiphospholipid antibodies were found in this patient as well as in other patients with thrombotic complications and/or purpura fulminans following varicella infection [3, 4, 10, 11]. It is possible that the simultaneous presence of a protein S deficiency and antiphospholipid antibodies concur to explain the severity of the clinical manifestation [4, 12].…”

Antiphospholipid syndrome associated with infections: clinical and microbiological characteristics

“…An adult patient who suffered a pulmonary embolus during the course of a varicella infection accompanied by transiently elevated levels of aCL and b2GPI has been documented (Viseux et al, 2000). Uthman et al (2001) reported a 16-year-old male who developed an ilio-femoral thrombosis 1 week following a chickenpox infection.…”

Antiphospholipid antibodies in response to infection

“…Thrombotic events associated with transient aPL have also been reported in a few cases of varicella-zoster virus (VZV) and Epstein-Barr virus infection [19][20]. Recently, Losurdo et al [21] described two pediatric cases with varicella-associated cerebrovascular disease that had positive IgM anti-2 -GPI antibodies and that became negative after 1 month.…”