Transient lupus anticoagulant associated with hypoprothrombinemia and Factor XII deficiency following adenovirus infection

Abstract

A potent lupus anticoagulant (LA) was detected in four children, 1 week after the clinical onset of an adenovirus infection. The adenovirus infection was documented by direct virus detection in the stool of one patient and serologically in the others. None of the children had elevated titers of IgM- and only one of IgG-anticardiolipin antibodies (ACA). All patients had a marked reduction of prothrombin activity as well as antigen. Prothrombin-antibody complexes were demonstrated in the patients' plasma or mixtures of patient and normal plasma. Factor XII activity was moderately reduced in three of the patients. All coagulation abnormalities returned to normal within 4-12 weeks. Localized bleeding was observed in two cases, but there was no generalized bleeding tendency or evidence of thrombosis.

Age-associated developmental changes in the activated partial thromboplastin time (APTT) and causes of prolonged APTT values in healthy Chinese children

“…The prevalence of transient and asymptomatic antiphospholipid antibodies (aPL) and/or LAC are more common in children than in adults (39)(40)(41)(42)(43)(44), which can be partly ascribed to acquired infections (39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Since children suffer from infections more often than adults, this might explain why children had a much higher prevalence for LAC than adults (42), especially in early childhood (43,44).…”

“…A frequent association of transient aPL and/or LAC with low factor XII exists (45,48,49). This suggests that aPL and/or LAC play a role in the pathogenesis of decreased factor XII in children.…”

Lupus anticoagulants in two children—bleeding due to nonphospholipid-dependent antiprothrombin antibodies

“…In addition there have been cases with acquired hypoprothrombinaemia and bleeding, most often in combination with LA [5,6,19,21,31,[8][9][10][11][12]26,32]. Haemorrhagic LA syndrome is rare, less than 30 patients are described in the medical literature, and it has been attributed to increased clearance of prothrombin caused by non-neutralizing antiprothrombin antibodies.…”

“…Haemorrhagic LA syndrome is rare, less than 30 patients are described in the medical literature, and it has been attributed to increased clearance of prothrombin caused by non-neutralizing antiprothrombin antibodies. Their signs and symptoms have varied from mild bleeding such as bruising and haematoma to severe gum bleeding, epistaxis and in two cases haemarthrosis [5,6,19,21,31,[8][9][10][11][12]26,32].…”

Cytomegalovirus pneumonitis, activated prothrombin time prolongation and subacute thyroiditis after unrelated allogeneic bone marrow transplantation

“…APTT prolongation and subacute thyroiditis occurred virtually simultaneously suggesting an association between a viral infection and APTT prolongation; recently, lupus anticoagulant associated with hypoprothrombinemia and factor XII deficiency following an adenovirus infection was reported. 17 This patient experienced various infectious episodes, CMV pneumonitis with markedly high levels of CMV antigemia and subacute thyroiditis after her BMT. CD4 ϩ cell recovery after BMT was incomplete, even after 1 year.…”