caa a22 4500 475785185 CHVBK 20180406123656.0 cr unu---uuuuu 170329e20000201xx s 000 0 eng 10.1007/s004310050052 doi (NATIONALLICENCE)springer-10.1007/s004310050052 Recurrent antiphospholipid-related deep vein thrombosis as presenting manifestation of systemic lupus erythematosus [Elektronische Daten] [Marco Gattorno, Angelo Claudio Molinari, Antonella Buoncompagni, Maura Acquila, Stefano Amato, Paolo Picco] Antiphospholipid antibodies (aPL) are frequently associated with thrombotic disorders in the so-called antiphospholipid syndrome. Together with anticardiolipin antibodies (aCL), lupus anticoagulant (LA) is the main diagnostic tool for aPL detection. Since LA determination is based on the finding of prolonged clotting time in vitro, concomitant anticoagulant therapy may significantly interfere with its detection. We report a case of a boy in whom recurrent aPL-related thrombosis heralded for several months the onset of systemic lupus erythematosus (SLE). Abnormally increased in vitro clotting times at the time of the second thrombotic event led to the suspicion of the presence of LA activity. However, this latter finding was difficult to interpret since the patient was already on heparin treatment at the time of our first observation. Thus, LA was assayed using a commercial kit in which a heparin neutralizer is included (Staclot LA). Two consecutive samples from the patient were compared with eight patients on anticoagulant therapy for non-aPL-related thrombotic events and 20 healthy controls. The study showed that, taking into account the concomitant anticoagulant treatment, Staclot LA was positive only in the propositus, raising the suspicion of a possible aPL-related origin of the thrombotic event. This issue was definitively confirmed in a subsequent follow-up. Conclusion The present report shows that aPL-related deep vein thrombosis can be the earliest clinical manifestation of pediatric SLE, and that Staclot LA may have a role in LA detection during the course of anticoagulant treatment. Springer-Verlag Berlin Heidelberg, 2000 Key words Pediatric systemic lupus erythematosus nationallicence Thrombosis nationallicence Antiphospholipid antibodies nationallicence Gattorno Marco 2nd Division of Pediatrics (Pediatric Rheumatology Unit), "G. Gaslini” Scientific Institute for Children, Largo G. Gaslini 5, 16147 Genoa, Italy e-mail (private): Sormani_Gattorno@iol.it; Fax: +39-010-3776590, IT aut Molinari Angelo Claudio 4th Division of Pediatrics (Pediatric Hematology Unit), "G. Gaslini” Scientific Institute for Children, Genoa, Italy, IT aut Buoncompagni Antonella 2nd Division of Pediatrics (Pediatric Rheumatology Unit), "G. Gaslini” Scientific Institute for Children, Largo G. Gaslini 5, 16147 Genoa, Italy e-mail (private): Sormani_Gattorno@iol.it; Fax: +39-010-3776590, IT aut Acquila Maura 4th Division of Pediatrics (Pediatric Hematology Unit), "G. Gaslini” Scientific Institute for Children, Genoa, Italy, IT aut Amato Stefano 4th Division of Pediatrics (Pediatric Hematology Unit), "G. Gaslini” Scientific Institute for Children, Genoa, Italy, IT aut Picco Paolo 2nd Division of Pediatrics (Pediatric Rheumatology Unit), "G. Gaslini” Scientific Institute for Children, Largo G. Gaslini 5, 16147 Genoa, Italy e-mail (private): Sormani_Gattorno@iol.it; Fax: +39-010-3776590, IT aut https://doi.org/10.1007/s004310050052 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004310050052 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gattorno Marco 2nd Division of Pediatrics (Pediatric Rheumatology Unit), "G. Gaslini” Scientific Institute for Children, Largo G. Gaslini 5, 16147 Genoa, Italy e-mail (private): Sormani_Gattorno@iol.it; Fax: +39-010-3776590, IT aut NATIONALLICENCE 700 1- Molinari Angelo Claudio 4th Division of Pediatrics (Pediatric Hematology Unit), "G. Gaslini” Scientific Institute for Children, Genoa, Italy, IT aut NATIONALLICENCE 700 1- Buoncompagni Antonella 2nd Division of Pediatrics (Pediatric Rheumatology Unit), "G. Gaslini” Scientific Institute for Children, Largo G. Gaslini 5, 16147 Genoa, Italy e-mail (private): Sormani_Gattorno@iol.it; Fax: +39-010-3776590, IT aut NATIONALLICENCE 700 1- Acquila Maura 4th Division of Pediatrics (Pediatric Hematology Unit), "G. Gaslini” Scientific Institute for Children, Genoa, Italy, IT aut NATIONALLICENCE 700 1- Amato Stefano 4th Division of Pediatrics (Pediatric Hematology Unit), "G. Gaslini” Scientific Institute for Children, Genoa, Italy, IT aut NATIONALLICENCE 700 1- Picco Paolo 2nd Division of Pediatrics (Pediatric Rheumatology Unit), "G. Gaslini” Scientific Institute for Children, Largo G. Gaslini 5, 16147 Genoa, Italy e-mail (private): Sormani_Gattorno@iol.it; Fax: +39-010-3776590, IT aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer