HIGH PREVALENCE OF ANTIPHOSPHOLIPID ANTIBODIES IN CHILDREN WITH IDIOPATHIC CEREBRAL-ISCHEMIA

Background. The presence of circulating antiphospholipid antibodies (a PLs) is frequently associated with thromboembolic phenomena. Objective . To investigate the prevalence of aPLs, detected as lupus anticoagula nt (LA) or anticardiolipin antibody (aCL), in a group of unselected ch ildren with idiopathic cerebral ischemia. Design. Prospective, case se ries. Setting. A pediatric neurology department. Patients. Thirteen ch ildren with cerebral ischemia (eight with stroke, three with transient ischemic attacks, and two with ocular ischemia). Age-matched apparent ly healthy children served as controls. Measurements. LA and aCL deter mination was performed within 3 days after the occurrence of the ische mic event and was repeated after 3 to 6 months. To be defined as aPL-p ositive, patients had to have either a positive LA test or positive Ig G and/or IgM aCL at moderate/high level in both determinations. Main r esults. Ten (76%) of the 13 patients were positive for either LA or aC L. No differences were found between aPL-positive and aPL-negative pat ients with respect to clinical manifestations or radiological features . Six (46%) of the 13 patients had a history of multiple ischemic even ts. Conclusions. Our results show a very high prevalence of aPLs in ch ildren with idiopathic cerebral ischemia. Because the presence of thes e antibodies has relevant therapeutic implications, their determinatio n in children with cerebral ischemia is recommended.