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Transient antiphospholipid antibodies associated with acute infections in children: a report of three cases and a review of the literature
Authors:H. Mizumoto  T. Maihara  E. Hiejima  M. Shiota  A. Hata  S. Seto  T. Atsumi  T. Koike  D. Hata
Affiliation:(1) Department of Pediatrics, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan;(2) Department of Pediatrics, Hyogo Prefectural Tsukaguchi Hospital, Amagasaki, Japan;(3) Department of Pediatrics, Kishiwada City Hospital, Kishiwada, Japan;(4) Department of Medicine II, Hokkaido University School of Medicine, Sapporo, Japan
Abstract:We describe two previously healthy children who had multiple ecchymoses several days after acute infection. In both cases, the prothrombin time (PT) and the activated partial thromboplastin time (APTT) were prolonged. Further examinations revealed the presence of lupus anticoagulant (LA), phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT), and low serum complement. In both cases, we confirmed the presence of a serum immune complex. The patients’ symptoms improved spontaneously within 1 week, and all laboratory data normalized within several months. We also describe another asymptomatic case positive for LA and aPS/PT presumably associated with cytomegalovirus infection. The prevalence of transient antiphospholipid antibodies associated with viral infections in children must be much higher than we expected. We have to take it into consideration when we see abnormal coagulation results, but the occurrence of significant bleeding symptoms is rare.
Keywords:Lupus anticoagulant  Phosphatidylserine-dependent antiprothrombin antibodies  Hypoprothrombinemia  Bleeding complications
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