Morbidity of lupus anticoagulants in children: a single institution experience

Casais, Patricia; Meschengieser, Susana S.; Gennari, Laura C.; Alberto, María Fabiana; Sánchez‐Luceros, Analía; Blanco, Alicia N.; Lazzari, M.A.

doi:10.1016/j.thromres.2004.06.006

Cited by 9 publications

(8 citation statements)

References 24 publications

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“…If an age-related trend to longer aPTTs in youngest patients was found for the two tested reagents, the prolongation was found to be more pronounced with the HemosIL APTT SP than with the HemosIL SynthASil, which could be related to increased sensitivity to lower factor levels (29). However, the prolongation of aPTT in children could also be due to the presence of transient lupus anticoagulant (LA) (30)(31)(32)(33)(34). In our series, the vast majority of sampled children was not suffering from any acute illness or infection, making unlikely that LA could account to a significant point to the reported aPTT prolongation in youngest children.…”

Section: Discussionmentioning

confidence: 99%

Age dependency for coagulation parameters in paediatric populations

Toulon¹,

Berruyer²,

Brionne-François³

et al. 2016

Thromb Haemost

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Understanding of developmental haemostasis is critical to ensure optimal prevention, diagnosis, and treatment of haemorrhagic and thrombotic diseases in children. As coagulation test results are known to be dependent on the reagents/analysers used, it is recommended for each laboratory to define the age-dependent reference ranges by using its own technical condition. That study was carried out in seven centers to establish age-specific reference ranges using the same reagents and analyser. Plasma samples were obtained from 1437 paediatric patients from the following age groups: 15 days-4 weeks (n=36), 1-5 months (n=320), 6-12 months (n=176), 1-5 years (n=507), 6-10 years (n=132) and 11-17 years (n=262). Indication of coagulation testing was pre-operative screening for non-acute diseases in most cases. PT values were similar in the different age groups to those in adults, whereas longer aPTTs were demonstrated in the younger children. Plasma levels of all clotting factors, except for FV, were significantly decreased (p<0.0001) in the youngest children, adult values being usually reached before the end of the first year. The same applied to antithrombin, protein C/S, and plasminogen. In contrast, FVIII and VWF levels were elevated in the youngest children and returned to adult values within six months. The same applied to D-dimer levels, which were found elevated, particularly until six months of life, until puberty. These data suggest that most coagulation test results are highly dependent on age, mainly during the first year of life, and that age-specific reference ranges must be used to ensure proper evaluation of coagulation in children.

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Section: Discussionmentioning

confidence: 99%

Age dependency for coagulation parameters in paediatric populations

Toulon¹,

Berruyer²,

Brionne-François³

et al. 2016

Thromb Haemost

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“…Nicotine consumption, surgical interventions, immobilization, trauma, lipometabolic disorders, oral contraception, dehydration, sepsis, autoimmune, perinatal and oncologic diseases are exogenous trigger factors [3, 4, 12, 16, 21, 35]. However, there is also a group of endogenous factors, namely hereditary dispositions, the number of which is steadily increasing [10, 11, 13].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Treatment of Thrombosis with Enoxaparin in Pediatric and Adolescent Patients

2006

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Thrombosis is a rare event in childhood and adolescence. Nevertheless, increasing numbers of invasive diagnostic and therapeutic procedures also result in increasing numbers of thromboses in pediatric cases, necessitating effective antithrombotic treatment regimens. In recent years, low-molecular-weight heparins (LMWH) in particular have been proved to be a safe and effective alternative to unfractioned heparins. However, the application of LMWH in pediatric patients has not been supported by a single controlled study so far. Furthermore, there is no official approval of these drugs for children. In this pilot study 27 children with deep venous thromboses (DVT) were treated with the LMWH enoxaparin at a dosage of 1.5 mg/kg body weight b.i.d. in neonates and infants and 1 mg/kg body weight b.i.d. in children. This dosage was lowered for prophylaxis if therapeutic success was achieved. The aim of the study was to investigate both, efficacy with respect to patency rates and safety during acute and long-term follow-up. Sufficient therapeutic success required a rapid production of anti-Xa target activity and was reached in 85% of the treated patients, who showed patency of the affected vessel at last follow-up. The mean duration of treatment with full dosage was 16.5 days, followed by prophylaxis over a mean duration of 9.8 months. Rethrombosis or adverse events including heparin-induced thrombocytopenia were not observed in any patient. In conclusion, enoxaparin provides an effective and safe alternative to unfractioned heparins in the treatment of thrombosis in infancy, childhood and adolescence.

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“…These values were concordant with those of the literature. [7][8][9][10][11][12] Our results show that the sensitivity of the aPTT test for revealing LA positivity is low while its specificity is high ( Table 2). In this condition, as seen in our study, it can be concluded that aPTT is insufficient to determine weak inhibitors and its sensitivity is low.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 These APA have been found to be associated with many infections, although the pathogenic role for these antibodies is still unknown. [1][2][3][4][7][8][9][10][11][12][13][14][15][16][17][18] The presence of LA is an important cause for delayed activated partial thromboplastin time (aPTT) test in children. In children, the presence of LA is usually transient, without causing any damage.…”

Section: Introductionmentioning

confidence: 99%