Kamat Anil V, D'Cruz David P, Hunt Beverley J
Department of Haematology, Guys' & St Thomas' Foundation Trust London SE1 7EH, UK.
Haematologica. 2006 Dec;91(12):1674-80.
Antiphospholipid antibodies (aPL) and antiphospholipid syndrome (APS) are increasingly being recognized in children. Transient non-pathogenic aPL are often seen after childhood infections, while thrombotic events seem rare in those with true aPL. We discuss the main scenarios faced when dealing with children with aPL--asymtomatic aPL, primary APS and secondary APS. Children with thrombotic events present difficult management problems, as there is little evidence-based medicine in this area. We discuss the manifestations and management of childhood aPL--asymptomatic aPL, primary and secondary APS elucidated with case histories. Insufficient safety data on anticoagulation and limited information on the effects of warfarin, use of aspirin, duration and intensity of anticoagulation are some of the unresolved issues in managing aPL and APS in children. Multicenter randomized controlled trials may provide answers to some of these issues.
抗磷脂抗体（aPL）和抗磷脂综合征（APS）在儿童中越来越受到关注。儿童感染后常可见短暂性非致病性aPL，而真正患有aPL的儿童发生血栓事件似乎很少见。我们讨论了在处理患有aPL的儿童时面临的主要情况——无症状aPL、原发性APS和继发性APS。患有血栓事件的儿童存在棘手的管理问题，因为该领域基于循证医学的依据很少。我们通过病例史阐述了儿童aPL的表现及管理——无症状aPL、原发性和继发性APS。抗凝的安全性数据不足、华法林的作用信息有限、阿司匹林的使用、抗凝的持续时间和强度是儿童aPL和APS管理中一些尚未解决的问题。多中心随机对照试验可能会为其中一些问题提供答案。
