ANTIPHOSPHOLIPID ANTIBODIES IN CEREBROVASCULAR ISCHEMIA AND STROKE INCHILDHOOD

We report on eight children who suffered from cerebrovascular ischemia or stroke at the age of 2 or up to 11 years. Antiphospholipid antibod ies (APLA) were detected in two cases during the ischemic event and in six cases during follow-up examinations (after six weeks or within a span of six years). In two patients multiple stenoses of basal cerebra l arteries were found; one of them suffered from moyamoya syndrome. Th e acute hemiplegia in one patient was linked to an asymptomatic mycopl asmal infection and APLA. In three cases, one of the parents was also APLA-positive. Seven patients were treated with acetylsalicylic acid, and in four cases immunoglobulin infusions were given. Transient ische mic attacks subsided after the child with the moyamoya syndrome receiv ed immunoglobulins. No effect of medication could be established in th e other children. The concept of the antiphospholipid syndrome is stil l evolving. As none of the common risk factors pertaining to strokes i n adults apply to children, pediatric research may offer a suitable pl atform for specific investigations on the causal, pathogenetic role of APLA. We propose that all children suffering from stroke or transient ischemic attacks should be tested for APLA.