Dong Rong-Jing, Lei Su-Yun, Li Jun, Yang Xin-Ping, Li Yu-Ye, Zhang Yun-Gui
Yunnan Provincial Hospital of Infectious Disease/Yunnan AIDS Care Center, Kunming, 650301, China.
Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China.
Thromb J. 2021 Mar 25;19(1):20. doi: 10.1186/s12959-021-00273-y.
Antiphospholipid syndrome (APS) is a non-inflammatory autoimmune disorder induced by antiphospholipid antibodies, which occurs exceedingly rarely in pediatric population and even more rarely reported in HIV positive children. A case of 11 years old boy had a sudden onset of swelling in his left lower leg along with pain which were worsening gradually. Initially, topical ointment was applied for 1 month which were ineffective in reducing pain and swelling. Instead, the symptoms were aggravated and suddenly spread to the proximal thigh, accompanied by dyskinesia of left lower leg. Both color doppler ultrasonography and vascular CT scan of left lower leg revealed deep venous thrombosis. His serum anti-phospholipid antibodies (aPLs) were tested positive. He was a known case of HIV virological failure with substantial HIV viral load (VL) despite receiving regular antiretroviral therapy (ART). His symptoms improved after giving aggressive antithrombotic and high dose corticosteroid treatments.
When pediatric patients develop thrombotic disease, APS also needs to be ruled out. The autoantibodies levels should be routinely tested to look for recurrent thrombosis in children with HIV/AIDS.
抗磷脂综合征（APS）是一种由抗磷脂抗体引起的非炎症性自身免疫性疾病，在儿科人群中极为罕见，在HIV阳性儿童中报道的更少。一名11岁男孩突然出现左小腿肿胀并伴有疼痛，且逐渐加重。最初，外用软膏涂抹1个月，对减轻疼痛和肿胀无效。相反，症状加重并突然蔓延至大腿近端，伴有左小腿运动障碍。左小腿彩色多普勒超声和血管CT扫描均显示深静脉血栓形成。其血清抗磷脂抗体（aPLs）检测呈阳性。尽管接受了常规抗逆转录病毒治疗（ART），但他是已知的HIV病毒学治疗失败病例，HIV病毒载量（VL）很高。给予积极的抗血栓和高剂量皮质类固醇治疗后，他的症状有所改善。
当儿科患者出现血栓性疾病时，也需要排除APS。对于HIV/AIDS儿童，应常规检测自身抗体水平以寻找复发性血栓形成。
