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Paediatric Rheumatology

 

Haematological and other manifestations in the presence of antiphospholipid antibodies in a multicentric paediatric cohort

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

 

  1. Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy, and Universidad de Alcalá, Madrid, Spain.
  2. Division of Rheumatology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
  3. Division of Rheumatology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
  4. Division of Haematology, Hospital Pediátrico Sant Joan de Déu, Barcelona, Spain.
  5. Division of Haematology, Hospital Pediátrico Sant Joan de Déu, Barcelona, Spain.
  6. Division of Rheumatology, Hospital Pediátrico Sant Joan de Déu, Barcelona, Spain.
  7. Division of Rheumatology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
  8. Division of Rheumatology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
  9. Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
  10. Medical Laboratory Unit, IRCCS, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
  11. Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy. fabrizio.debenedetti@opbg.net
  12. Division of Rheumatology, Hospital Pediátrico Sant Joan de Déu, Barcelona, Spain.
  13. Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.

CER16662
2023 Vol.41, N°11
PI 2331, PF 2337
Paediatric Rheumatology

purchase article

PMID: 37706308 [PubMed]

Received: 09/03/2023
Accepted : 24/05/2023
In Press: 08/09/2023
Published: 14/11/2023

Abstract

OBJECTIVES:
To identify the variables associated with the development of haematological manifestations in the presence of antiphospholipid antibodies (aPLs) in a paediatric cohort.
METHODS:
We conducted a multicentric retrospective cohort study of children under the age of 18 years.
RESULTS:
One hundred and thirty-four children were included; 12.2% had at least one thrombotic event (TE) and 67% at least one non-criterion manifestation. Of them, 90% did not develop any TE. Haematological manifestations were the most frequent (42%), followed by neurological (19.8%), cutaneous (17.6%), cardiac (16.8%) and renal (1.5%) manifestations. In those children with haematological disorders, the aPLs positivity rate was: 67.3% LA, 65.6% aβ2GPI, 60% aCL, 45.5% single, 23.6% double and 30.9% triple. A univariate analysis showed that children with IgM aCL+, IgM aβ2GPI+, triple positivity and with a SLE diagnosis had a significantly higher frequency of haematological manifestations (p<0.05). Finally, a stepwise regression analysis identified IgG aβ2GPI positivity [OR 2.91, 95% CI (1.26–6.74), p=0.013], SLE [OR 2.67, 95% CI (1.13–6.3), p=0.026] and LA positivity [OR 2.53, 95% CI (1.08–5.94), p=0.033] as independent risk factors for the development of haematological manifestations.
CONCLUSIONS:
Non-criteria manifestations and among them haematological disorders, are the most frequent events in the presence of aPLs and/or LA in our paediatric cohort. Children with SLE, LA and/or IgG aβ2GPI positivity showed a higher risk of haematological manifestations.

DOI: https://doi.org/10.55563/clinexprheumatol/3mzh06

Rheumatology Article