Non-thrombotic manifestations in pediatric patients with persistent antiphospholipid antibodies. A Mexican tertiary center case series

Introduction Antiphospholipid antibodies (aPL) are a group of autoantibodies classically associated with antiphospholipid syndrome (APS), a disease strongly linked to thrombosis and pregnancy loss. However, non-thrombotic manifestations are increasingly reported, including neurological, hematological, renal, and cardiac involvement. Information is limited at this level. Understanding the role of these antibodies is fundamental to rheumatological practice, especially in the pediatric population where information on this topic is limited. Objective To describe non-thrombotic characteristics in pediatric patients with positive antiphospholipid antibodies at a tertiary care hospital in Mexico. Material and methods A retrospective, observational, descriptive study was conducted. This study documented non-thrombotic clinical manifestations in pediatric patients with persistently positive antiphospholipid antibodies. Our patients did not meet the diagnostic criteria for antiphospholipid syndrome. Patients with thrombosis were not included in this study. All patients were evaluated by the pediatric rheumatology team. Results Eighteen patients were included. Hematological alterations were the most prevalent (72% of patients presented with characteristics, including thrombocytopenia, hemolytic anemia, or leukopenia), followed by neurological manifestations. The most frequent antibody was anti-beta-2-glycoprotein-1, and 22% of patients had a triple positive profile. Conclusion The most frequent manifestation reported in our group of patients with positive antiphospholipid antibodies was thrombocytopenia and hematological manifestations in general. The principal antibody reported was the anti-beta-2-glycoprotein-1. We need more studies to get a better understanding about the relation between positive antiphospholipid antibodies and non-thrombotic features.