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Neonatal arterial ischemic stroke: Which thrombotic biological risk factors to investigate and which practical consequences?
Abstract All biological risk factors that have been previously identified to increase the risk of thrombosis in adults, have also been studied in neonates with arterial Ischemic Stroke (NAIS), but most studies were retrospective and included relatively low numbers of affected children. We therefore could not suggest recommendations with a strong level of evidence and only expert proposals potentially useful for clinical practice will be presented in this text. Despite these limitations, the extensive analysis of published data supported that factor V Leiden (FVL) and increased levels of Lp(a) could be significant ...
Source: Archives de Pediatrie - September 1, 2017 Category: Pediatrics Authors: Perez T, Valentin JB, Saliba E, Gruel Y Tags: Arch Pediatr Source Type: research

How to use... lupus anticoagulants
Introduction Lupus anticoagulants (LA) were first detected in patients with systemic lupus erythematosus (SLE) in 1952 by Conley and Hartmann.1 They identified patients in whom the activated partial thromboplastin time (APTT) was prolonged and which did not correct on the addition of normal plasma. Although Conley and Hartmann's original description was in association with a haemorrhagic disorder, subsequent reports from the 1960s highlighted patients with thrombotic events in the presence of LA.2 The term ‘lupus anticoagulant’ was introduced by Feinstein and Rapaport in 1972.3 It has, however, caused some conf...
Source: Archives of Disease in Childhood - Education and Practice - March 14, 2013 Category: Pediatrics Authors: Sen, E. S., Beresford, M. W., Avcin, T., Ramanan, A. V. Tags: Liver disease, Immunology (including allergy), Hepatitis and other GI infections, Travel medicine, Epilepsy and seizures, Headache (including migraine), Stroke, Pregnancy, Reproductive medicine, Rheumatology Interpretations Source Type: research

Fitting and flailing: recognition of paediatric antiphospholipid syndrome
We present two cases of paediatric APS, who presented with primary neurological events, and discuss approaches to diagnosis, interpretation of screening investigations, including antinuclear antibodies (ANA), anti-extractable nuclear antigen (ENA) antibodies and lupus anticoagulant. Possible approaches to the management of paediatric APS are discussed.
Source: Archives of Disease in Childhood - Education and Practice - January 13, 2014 Category: Pediatrics Authors: Freeman, H., Patel, J., Fernandez, D., Sharples, P., Ramanan, A. V. Tags: Immunology (including allergy), Drugs: cardiovascular system, Stroke, Screening (epidemiology), Screening (public health) Problem solving in clinical practice Source Type: research

Childhood lupus with microangiopathic antiphospholipid syndrome and pulmonary hemorrhage.
Abstract BACKGROUND: Concurrent thrombotic and hemorrhagic manifestations are uncommon in patients with Antiphospholipid Syndrome. CASE CHARACTERISTICS: A 10-year-old girl with fever, edema, rash and joint pains, who later developed deep venous thrombosis (DVT), stroke, thrombotic microangiopathic hemolytic anemia and pulmonary hemorrhage. Investigations confirmed Antiphospholipid syndrome associated with systemic lupus erythematosus. OUTCOME: She went into complete remission with intravenous immunoglobulins, plasmapheresis, immunosuppression and anticoagulation. MESSAGE: Thrombotic microangiopathic...
Source: Indian Pediatrics - April 8, 2015 Category: Pediatrics Authors: Bhadauria D, Etta P, Kaul A, Prasad N Tags: Indian Pediatr Source Type: research

What Are Common Inherited Thrombophilias?
Discussion Thrombophilia is the increased risk of thromboembolic disease due to a disorder. Thrombophilia can be inherited or acquired (such as antiphospholipid syndrome). The risk of thromboembolic events is much lower in children than adults. At-risk patients should avoid: Dehydration Sitting for prolonged time periods during travel Obesity Smoking Estrogen containing oral contraceptives Common inherited thrombophilias include: Prothrombin (Factor II mutation) Second most common Genetics: 1-2% prevalence is variable depending on location and ethnic background. Cause: Abnormal point mutation of the prothrombin gene t...
Source: PediatricEducation.org - May 25, 2015 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news