Carvalho Cristiana, Viveiro Carolina, Maia Paulo, Rezende Teresa
Department of Pediatria, Centro Hospitalar de Leiria-Pombal, Leiria, Portugal.
BMJ Case Rep. 2013 Jan 7;2013:bcr2012007948. doi: 10.1136/bcr-2012-007948.
Acquired inhibitors of coagulation causing bleeding manifestations are rare in children. They emerge, normally in the context of autoimmune diseases or drug ingestion, but transient and self-limiting cases can occur after viral infection. We describe, an otherwise healthy, 7-year-old girl who had gingival bleeding after a tooth extraction. The prothrombin time (PT) and the activated partial thromboplastin time (APTT) were both prolonged with evidence of an immediate acting inhibitor (lupic anticoagulant). Further coagulation studies demonstrated prothrombin (FII) deficiency and prothrombin directed (FII) antibodies. The serological tests to detect an underlying autoimmune disease were all negative. The coagulation studies normalised alongside the disappearance of the antibody. This article presents lupus anticoagulant hypoprothrombinaemia syndrome (LAHS) as a rare case of acquired bleeding diathesis in childhood.
获得性凝血抑制物导致出血表现的情况在儿童中很少见。它们通常在自身免疫性疾病或药物摄入的背景下出现,但病毒感染后也可能发生短暂和自限性的病例。我们描述了一名原本健康的7岁女孩,她在拔牙后出现牙龈出血。凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)均延长,有即时作用抑制剂(狼疮抗凝物)的证据。进一步的凝血研究显示凝血酶原(FII)缺乏和凝血酶原定向(FII)抗体。检测潜在自身免疫性疾病的血清学检查均为阴性。随着抗体的消失,凝血研究恢复正常。本文介绍了狼疮抗凝物低凝血酶原血症综合征(LAHS),这是儿童期获得性出血素质的罕见病例。