PB0616 - Antiphospholipid syndrome in pediatric population

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

TM

Tania Marisol Martinez Garcia

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico

Co-Author(s)

Emely J. Soriano, MD

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
ML

María Graciela Leal Gutiérrez

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
Stephania Sandoval Ocampo, Hematologist

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Ciudad de méxico, Mexico City, Mexico
Andric Cuevas-Juárez, MD

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico city, Distrito Federal, Mexico
Marilyn G. Mendoza, MD

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
Margarita M. Thomas, MD

Medical Resident on Thrombosis and Hemostasis
1Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico city, Distrito Federal, Mexico
Jose A. Aguilar

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Ciudad de México, Distrito Federal, Mexico
Abraham S. Majluf

Head of the thrombosis and hemostasis unit
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
AG

Adriana Guadalupe García Gonzalez

Medical resident of thrombosis and hemostasia
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Ciudad de Mexico, Distrito Federal, Mexico

Background: Antiphospholipid syndrome (APS) is an acquired, systemic, autoimmune disorder characterized by arterial and/or venous thrombotic events, recurrent fetal loss, and persistent positive antiphospholipid antibodies (aPL). Current evidence is scarce regarding this entity in pediatric population.

Aims: To describe the clinical and laboratory characteristics of a Mexican pediatric population with APS.

Methods: An ambispective, descriptive, 15-year follow-up study period. Clinical and immunological features of 21 patients were analyzed. Current Sapporo criteria were used to establish the diagnosis. Thrombotic and hemorrhagic events before and after antithrombotic treatment were all objectively evidenced. Hemorrhage was classified according to ISTH criteria.

Results: Twenty-one patients were diagnosed (age range: 3-16 years), 17 women and 4 men. Lupus anticoagulant (LA), was positive in 90.4% of the patients and 52.3% of them had positive triple marker. All patients received VKAs (INR=2.0-3.0). Three LA+ adolescent patients were eventually switched to DOACs due to the difficulty to achieve a stable INR. A higher frequency of venous vs. arterial thrombosis was observed: only two patients suffered arterial thrombosis at the beginning. At the beginning of the registry, a significant percentage of patients did not receive antithrombotic treatment and, as a consequence, several recurrent thrombosis occurred before being attended at our service. Recurrences under anticoagulant treatment occurred in one patient while two patients had a re-thrombosis while under antiplatelet monotherapy.

Conclusion(s): This study shows a suboptimal antithrombotic treatment of patients with APS. More information of APS pediatric patients is required to establish the best therapy and to reduce thrombotic events.