Transient hemorrhagic diathesis associated with an inhibitor of prothrombin with lupus anticoagulant in a 1 1/2-year-old girl: report of a case and review of the literature

American Journal of Hematology
M T LeeM Karpatkin

Abstract

Acquired inhibitors of coagulation causing bleeding manifestations are rare in children, particularly without an associated underlying disorder such as autoimmune disease. We describe an otherwise healthy 1 1/2-year-old girl who had extensive spontaneous bruising and prolonged bleeding from venipuncture sites. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged, with evidence of an immediate-acting inhibitor. Thrombin clotting time, fibrinogen, and platelets were normal. Biologic assay of factors II, V, VII, and X were all low, with increasing values at higher dilutions. However, by immunoassay and/or chromogenic assays, only factor II was reduced. An antibody which failed to neutralize prothrombin activity in vitro was detected against radiolabeled prothrombin. Coagulation studies normalized in parallel with clinical recovery and disappearance of the antibody. This case demonstrates acute hypoprothrombinemia-lupus anticoagulant syndrome as a rare presentation of bleeding diathesis in a healthy young child.

References

Apr 1, 1979·American Journal of Clinical Pathology·D W BeckR A Henriksen
Aug 1, 1978·The Journal of Pediatrics·K MillerJ R Edson
Jul 1, 1978·Acta paediatrica Scandinavica·K B LillquistM Krogh-Jensen
Nov 27, 1976·British Medical Journal·P J KirkA Aronstam
Aug 1, 1991·The Journal of Infectious Diseases·J CollazosJ de Miguel
Aug 1, 1991·British Journal of Rheumatology·R J HiftB D Sarembock
Jan 22, 1988·JAMA : the Journal of the American Medical Association·D A TriplettC A Orr
Jan 1, 1985·The American Journal of Pediatric Hematology/oncology·F L Johnson
Jan 1, 1974·Haemostasis·K Lechner
May 1, 1973·British Journal of Haematology·M Karpatkin, S Karpatkin
Jul 1, 1983·Acta paediatrica Scandinavica·A LabbeM Coulet
Jan 1, 1984·The American Journal of Pediatric Hematology/oncology·Z Currimbhoy
Jan 1, 1982·Acta Haematologica·K NakashimaT Kaneko
Mar 1, 1980·The Journal of Pediatrics·G M BrodeurJ A Willimas
May 1, 1994·The American Journal of the Medical Sciences·N W Peacock, S P Levine
Dec 1, 1993·The Journal of Pediatrics·J C BerniniJ Ashcraft
Jan 1, 1959·American Journal of Clinical Pathology·J B FOSTERL B DOTTI

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Citations

Jul 1, 2006·Journal of Neuroinflammation·Hsiao-Wen LinSteven W Levison
Aug 2, 2006·Rheumatic Diseases Clinics of North America·Rolando Cimaz, Elodie Descloux
Apr 10, 2015·Current Rheumatology Reports·Cassyanne L AguiarBarry L Myones
Jul 31, 2016·American Journal of Clinical Pathology·Jing Jin, James L Zehnder
Nov 20, 2016·Pediatric Blood & Cancer·Aimee FoordArash Mahajerin
Nov 12, 2009·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Erdal PekerBaran Aydemir
Nov 14, 1998·Lupus·D A Triplett
Aug 9, 2017·Journal of Pediatric Hematology/oncology·Patcharee KomvilaisakSurapon Wiangnon
Apr 25, 2012·European Journal of Pediatrics·Karin KnobeAndreas Hillarp
May 2, 2015·Haemophilia : the Official Journal of the World Federation of Hemophilia·T SarkerM Rajpurkar
Oct 2, 2020·Journal of the American College of Emergency Physicians Open·Laura Scieszka, Tricia B Swan
Jan 27, 2021·Clinics in Laboratory Medicine·HyoJeong HanJun Teruya

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