Clin Pediatr Hematol Oncol.  2023 Apr;30(1):36-41. 10.15264/cpho.2023.30.1.36.

Long-Term Anticoagulation Therapy for Antiphospholipid Syndrome Following Unsuccessful Arterial Thrombosis Stent Procedure: A Case Report

• Kang HS

• KMID: 2542114
• DOI: http://doi.org/10.15264/cpho.2023.30.1.36

Abstract

Antiphospholipid syndrome (APS) is an autoimmune, multisystemic disorder marked by arterial, venous, or small-vessel thromboembolic events and persistence of antiphospholipid antibodies (aPL). Approximately 50% of APS patients exhibit primary disease features, while the remainder present with concurrent systemic autoimmune conditions. Venous thromboses are more common than arterial thromboses, with the latter primarily developing within the cerebral arteries, as in transient ischemic attacks or strokes. The incidence of thrombosis is higher in cases of APS with systemic lupus erythematosus than in primary APS. Thrombocytopenia, observed in 20-40% of APS patients, is generally moderate, asymptomatic, and does not require intervention. Thrombosis may be linked to autoimmune hemolysis, both of which are associated with aPL. Triple positivity, a high-risk serological profile, including lupus erythematosus, anti-cardiolipin antibodies, and anti-B2 glycoprotein I antibodies, is related to aPL. Positive results for all three serologic tests significantly increase thrombosis risk, necessitating continuous aspirin and warfarin use to mitigate risk. We here report a case involving a 15-year-old girl with triple-positive APS who underwent unsuccessful thrombolysis and balloon catheter dilation procedures and required long-term arterial thrombosis treatment with aspirin and warfarin.

Keyword

Adolescent; Antiphospholipid syndrome; Lupus erythematosus; Systemic; Thrombosis