Research Article
Volume 9 Issue 3 - 2020
Antiphospholipid Syndrome in Mexican Children: Evolution, Laboratory and Clinical Characteristics: An 18-Year Experience
Maria Teresa Braña Ruiz* and E Faugier-Fuentes
Pediatric Rheumatology, Hospital Infantile de Mexico Federico Gomez, Mexico
*Corresponding Author: Maria Teresa Braña Ruiz, Pediatric Rheumatology, Hospital Infantile de Mexico Federico Gomez, Mexico.
Received: December 10, 2019; Published: February 25, 2020




Abstract

Introduction: Antiphospholipid syndrome (APS) is an autoimmune, multisystemic disease characterized by the presence of thrombotic events, gestational morbidity, as well as hematological, dermatological and neurological manifestations, in the presence of high titers of antiphospholipid antibodies. It can present as primary, an isolated clinical entity, or secondary, as a manifestation of a rheumatologic disease, primarily systemic lupus erythematosus. 35 years after its first description, the understanding of this pathology is still evolving and even more so in the presentation in children.

Objective: To do a demographic description of pediatric population with APS in our hospital, allowing us to establish diagnostic criteria and targeted therapeutic management. It will also allow a prompt diagnosis, avoiding the morbidity and mortality associated with this pathology.

Materials and Methods: We performed a descriptive cross-sectional study. We searched in our archives for patients under 16 years of age, evaluated at the Hospital Infantil de Mexico Federico Gomez from March 2000 to March 2018 that met Sapporo criteria for classification of antiphospholipid syndrome.

Results: By reviewing the archives, we documented 29 patients were met Sapporo criteria for classification of APS from March 2000 to March 2018 at Hospital Infantil de Mexico Federico Gomez. 52% of the patients were female, while 48% male. The average age of patients was 9.8 years, with a minimum of 2.2 and a maximum of 16 years. The mean age at diagnosis was 14.8 years, with a standard deviation of 4.56 (range from 6.2 to 14.2 years). Of the 29 patients, 48% were diagnosed with primary APS, while 52% with secondary. Systemic Lupus Erythematosus was the primary rheumatologic disease in all the cases of secondary APS. 

Conclusion: Antiphospholipid syndrome is a complex and not well described pathology in pediatric population. Its variable presentation and unpredictable nature implies a diagnostic and treatment challenge for pediatricians. Epidemiological description of the pediatric population with APS at our hospital is very valuable for the development of diagnostic and therapeutic guidelines. Future reviews, in correlation with reviews from tertiary international rheumatologic centers are needed.

Keywords: Antiphospholipid Syndrome (APS); Mexican Children; Arterial Thrombosis; Venous Thrombosis

References

  1. Petty RE., et al. “Cassidys textbook of pediatric rheumatology”. 7th edition. Philadelphia, PA: Elsevier (2016).
  2. Miyakis S., et al. “International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS)”. Journal of Thrombosis and Haemostasis 4 (2006): 295-306.
  3. R Cervera., et al. “Antiphospholipid syndrome clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients”. Arthritis and Rheumatology 46 (2002): 1019-1027.
  4. B Tavil., et al. “Antiphospholipid antibodies in Turkish children with thrombosis”. Blood Coagulation and Fibrinolysis 18 (2007): 347-352.
  5. T Avcin., et al. “Pediatric antiphospholipid syndrome: clinical and immunologic features of 121 patients in an international registry”. Pediatrics 122 (2008): e1100-e1107. 
  6. FC Arnett., et al. “Associations of anti- beta2-glycoprotein I autoantibodies with HLA class II alleles in three ethnic groups”. Arthritis and Rheumatology 42 (1999): 268-274. 
  7. Thomas R. “Hypercoagulability syndromes”. Archives of Internal Medicine 161 (2001): 2433-2439. 
  8. Frances C. et al. “Dermatologic manifestations of the antiphospholipid syndrome: two hundred consecutive cases”. Arthritis Rheum. 52 (2005): 1785-1793. 
  9. Garcia DMD and Erkan DMD. “Diagnosis and Management of the Antiphospholipid Syndrome”. The New England Journal of Medicine (2018).
  10. Schreiber K., et al. “Antiphospholipid Syndrome”. Primer. Natures Review, Disease Primers 4 (2018). 
  11. R Cervera J., et al. “Antiphospholipid syndrome clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients”. Arthritis and Rheumatology 46 (2002): 1019-1027. 
  12. A Zamora-Ustaran., et al. “Garcia-Carrasco, et al., Antiphospholipid syndrome in Mexican children”. The Israel Medical Association Journal 14 (2012): 286-289. 
  13. ML Bertolaccini., et al. “Non-criteria’ aPL tests: report of a task force and preconference workshop at the 13th International Congress on Antiphospholipid Antibodies, Galveston, TX, USA, April 2010”. Lupus 20 (2011): 191-205.
  14. Merashli, M., et al. “Antiphospholipid syndrome: an update”. European Journal of Clinical Investigation 45 (2015).
  15. Espinosa G and Cervera R. “Current treatment of antiphospholipid syndrome: lights and shadows”. Nature Reviews of Rheumatology 11 (2015): 586-596.
  16. Sciascia. S., et al. “Diagnosing antiphospholipid syndrome: ‘extra-criteria’ manifestations and technical advances”. Nature Reviews of Rheumatology (2017). 
  17. Gerosa M., et al. “Recognition and management of antiphospholipid syndrome”. Review, Current Opinion (2015): 1040-8711.
  18. Reynaud Q., et al. “Risk of venous and arterial thrombosis according to type of antiphospholipid antibodies in adults without systemic lupus erythematosus: A systematic review and meta-analysis”. Autoimmunity Reviews 13 (2014): 595-608.
  19. Giannakopoulos B and Krilis S. “The Pathogenesis of the Antiphospholipid Syndrome”. The New England Journal of Medicine 368 (2013): 1033-1044. 
  20. Meroni M., et al. “Pathogenesis of antiphospholipid syndrome: understanding the antibodies”. Nature Reviews Rheumatology 7 (2011): 330-339. 
  21. C Kearon. “Antithrombotic therapy and prevention of thrombosis”. 9th edition. Chest (2012).
Citation: Maria Teresa Braña Ruiz and E Faugier-Fuentes. “Antiphospholipid Syndrome in Mexican Children: Evolution, Laboratory and Clinical Characteristics: An 18-Year Experience”. EC Paediatrics 9.3 (2020): 01-07.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


December Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 23, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.