Thrombotic and hemorrhagic complications in children with the lupus anticoagulant
M. L. Bernstein, M. Salusinsky-Sternbach, M. Bellefleur and D. W. Esseltine
Endogenous circulating anticoagulants are unusual in children without a
congenital factor deficiency. In particular, the lupus anticoagulant has
only rarely been reported in children. Despite its functioning in vitro to
prolong the partial thromboplastin time, patients more frequently have
problems with thrombosis than bleeding, unless there is a coexistent
prothrombin deficiency or thrombocytopenia. We report the cases of three
children with the lupus anticoagulant. Two children had associated
thromboses. One had a thrombosis of the iliofemoral system and the other
had a partial Budd-Chiari syndrome, a thrombosis of the deep calf veins and
ureteric obstruction. The third child had a concomitant prothrombin
deficiency and bleeding after tooth extraction. Associated findings in
these patients included a positive antinuclear antibody test in two, a
positive anti-DNA antibody test in two, a false-positive VDRL test in two,
and an antiphospholipid antibody test in two.
