Arabshahi B, Thompson E D, Smergel E M, Goldsmith D P
Section of Rheumatology, St. Christopher's Hospital for Children/Drexel University College of Medicine, Philadelphia, PA, USA.
Clin Rheumatol. 2007 Feb;26(2):251-3. doi: 10.1007/s10067-005-0127-8. Epub 2005 Dec 3.
We report a now 13-year-old male with trisomy 21, hypothyroidism, and insulin-dependent diabetes who developed acute hemiplegia due to the antiphospholipid antibody syndrome (APS) at age four. The risks of long-term anticoagulation were initially considered to be high; hence, he was treated with monthly infusions of intravenous immunoglobulin (IVIG) at 2 g/kg for 2 years and then every other month for 7 years. Antiphospholipid antibodies were no longer detectable within 6 months and have continued to be negative. There was no clinical deterioration or further changes on magnetic resonance arteriography over 7 years. IVIG may be an alternative therapeutic choice for children with APS who are not candidates for conventional anticoagulation.
我们报告了一名现年13岁的男性，患有21三体综合征、甲状腺功能减退症和胰岛素依赖型糖尿病，其在4岁时因抗磷脂抗体综合征（APS）出现急性偏瘫。长期抗凝的风险最初被认为很高；因此，他接受了为期2年、每月静脉注射免疫球蛋白（IVIG）2 g/kg的治疗，之后7年每两个月注射一次。抗磷脂抗体在6个月内不再可检测到，并且一直保持阴性。7年来，磁共振血管造影未发现临床恶化或进一步变化。对于不适合常规抗凝的APS儿童，IVIG可能是一种替代治疗选择。
