Antiphospholipid antibodies and cerebrovascular thrombosis in the pediatric population: Few answers to many questions
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Course
Antiphospholipid antibodies and cerebrovascular
Institution
Antiphospholipid Antibodies And Cerebrovascular
2. Antiphospholipid antibodies and cerebral thrombosis
2.1. Lupus anticoagulant
In neonates and children, LAC are sometimes found incidentally due to prolongation of activated
partial thromboplastin time (20). As LAC can be transient and associated with infections and
transplacental passage (...
AperTO - Archivio Istituzionale Open Access dell'Università di Torino
Antiphospholipid antibodies and cerebrovascular thrombosis in the pediatric population: Few
answers to many questions
This is the author's manuscript
Original Citation:
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This version is available http://hdl.handle.net/2318/1795807 since 2021-08-04T11:59:06Z
Published version:
DOI:10.1177/09612033211021488
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10 December 2023
,Title
Antiphospholipid antibodies and cerebrovascular thrombosis in the pediatric population: Few answers to
many questions
1
, Abstract
Most of the knowledge in pediatric antiphospholipid syndrome (APS) is derived from studies
performed on the adult population. As in adults, antiphospholipid antibodies (aPL) can contribute to
thrombosis, especially cerebrovascular thrombosis, in neonates and children. Since aPL have the
potential to cross the placental barrier, and since the pediatric population is prone to infections,
confirmation tests are required to specify a role for aPL in cerebrovascular thrombosis. In this review, we
aimed at assessing the prevalence of aPL, criteria or non-criteria, in neonatal and childhood ischemic
stroke and sinovenous thrombosis. Also, we looked into the effect of aPL and anticoagulants/antiplatelets
on the long term neurological outcomes of affected neonates or children. While most questions remained
un-answered because of the very limited evidence, the neurological outcomes seem to be affected by the
titers of aPL at the time of the event and subsequent confirmatory tests. In the settings of pediatric
population, anti-beta-2 glycoprotein I antibodies (anti-β2GPI) antibodies have been associated with
unusual arterial locations. Long term administration of aspirin has been safe, even though neurological
complications have been noted. Anticoagulation with low-molecular-weight heparin (LMWH) or vitamin K
antagonists, especially in combination with aspirin, has shown favorable outcomes in few cases.
However, the limited amount of data requires caution when interpreting the available evidence, especially
when referring to the most optimal choice of anticoagulation.
Keywords: Antiphospholipid antibodies; pediatric population; cerebrovascular thrombosis; anticoagulation
2
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