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Antiphospholipid antibodies and antiphospholipid syndrome in 57 children and adolescents with systemic lupus erythematosus

Paediatric Rheumatology Unit of the Children’s Institute, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil, barcelos.ops{at}terra.com.br

M H Kiss

University of São Paulo Medical School, São Paulo, Brazil

É A D’Amico

Haematology Unit of Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil

C A Almeida Silva

Paediatric Rheumatology Unit of the Children’s Institute, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil

The presence of antiphospholipid (aPL) antibodies and antiphospholipid syndrome (APS) was researchedin 57 childrenand adolescentswith systemic lupus erythematosus(SLE). The frequencyof aPL antibodies was 75.4% (anticardiolipin70.2% and lupus anticoagulant29.1%). The positivity for these antibodies fluctuated during the course of the disease. No association was found between aPL antibodiesand clinical or laboratory manifestationsor the autoantibodiesstudied, nor with the activity or gravity of the SLE. APS was diagnosed in 14% of the cases (eight patients), on average three years after the diagnosis of SLE. Four patients had arterial thrombosis (stroke, three; transient ischaemic attack, one; amaurosis fugax, two; renal, one), one presented with deep vein thrombosis (DVT) and three had involvement of small calibre vessels (osteonecrosis, two; transverse myelitis, one). Recurrences were observed in three of the eight cases (37.5%), with a mean interval of 13 months between the events. The presence of APS was associated with haemolytic anaemia, leukopenia, thrombocytopenia, coagulation abnormalities, ischaemic cerebrovascularaccidents, amaurosis fugax, osteonecrosisand interstitial pneumonitis. A negative association was observed between APS and the presence of anti-Ro antibodies.

Key Words: antiphospholipid antibodies • antiphospholipid syndrome • children • systemic lupus erythematosus

Lupus, Vol. 12, No. 11, 820-826 (2003)
DOI: 10.1191/0961203303lu471oa


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