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Venous Thromboembolic Disease in Children Associated with COVID-19

Venous thromboembolism (VTE) in children is rare and VTE in association with antiphospholipid antibodies (lupus anticoagulant, cardiolipin antibodies and beta-2 glycoprotein I) is even rarer. The development of these antibodies can be due to an acute infection or an autoimmune disease. Recently, the...

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Autores principales: Narang, Shalu, Morparia, Kavita, Sharma, Prachi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society of Hematology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330222/
http://dx.doi.org/10.1182/blood-2020-142964
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author Narang, Shalu
Morparia, Kavita
Sharma, Prachi
author_facet Narang, Shalu
Morparia, Kavita
Sharma, Prachi
author_sort Narang, Shalu
collection PubMed
description Venous thromboembolism (VTE) in children is rare and VTE in association with antiphospholipid antibodies (lupus anticoagulant, cardiolipin antibodies and beta-2 glycoprotein I) is even rarer. The development of these antibodies can be due to an acute infection or an autoimmune disease. Recently, these antibodies have been noted to be present in conjunction with SARS-CoV-2 in adult patients with VTE. We report 5 cases of VTE associated with presence of antiphospholipid antibodies in children over a short period during the coronavirus 19 pandemic. One child had SARS-CoV-2 PCR positive on nasopharyngeal swab while 2 had positive antibodies (IgM) to SARS-CoV-2. One adolescent female had features of Multi-Inflammatory System in Children (MIS-C) a few weeks before presenting with multiple pulmonary emboli and DVT. Thrombotic events included DVT of lower extremity (3 patients), multiple PE (2 patients), orbital vein thrombosis (1 patient) and upper extremity DVT (1 patient). Two of these patients had both DVT and PE. All patients had one or more antiphospholipid antibody present. Two adolescent females had new onset of systemic lupus erythematous. All patients were treated with systemic anticoagulation with heparin (initially with unfractionated heparin if clinically unstable and later changed to low molecular weight heparin). We report a cluster of adolescents with unusual thrombotic complications with antiphospholipid antibody positivity during the coronavirus 19 pandemic, 3 with positive virologic criteria, one with delayed presentation after MIS-C like features and one with close family member exposure. We hypothesize that VTE in children is likely due to development of antiphospholipid antibodies when associated with SARS-CoV-2 infection. [Figure: see text] DISCLOSURES: No relevant conflicts of interest to declare.
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spelling pubmed-83302222021-08-03 Venous Thromboembolic Disease in Children Associated with COVID-19 Narang, Shalu Morparia, Kavita Sharma, Prachi Blood 322.Disorders of Coagulation or Fibrinolysis Venous thromboembolism (VTE) in children is rare and VTE in association with antiphospholipid antibodies (lupus anticoagulant, cardiolipin antibodies and beta-2 glycoprotein I) is even rarer. The development of these antibodies can be due to an acute infection or an autoimmune disease. Recently, these antibodies have been noted to be present in conjunction with SARS-CoV-2 in adult patients with VTE. We report 5 cases of VTE associated with presence of antiphospholipid antibodies in children over a short period during the coronavirus 19 pandemic. One child had SARS-CoV-2 PCR positive on nasopharyngeal swab while 2 had positive antibodies (IgM) to SARS-CoV-2. One adolescent female had features of Multi-Inflammatory System in Children (MIS-C) a few weeks before presenting with multiple pulmonary emboli and DVT. Thrombotic events included DVT of lower extremity (3 patients), multiple PE (2 patients), orbital vein thrombosis (1 patient) and upper extremity DVT (1 patient). Two of these patients had both DVT and PE. All patients had one or more antiphospholipid antibody present. Two adolescent females had new onset of systemic lupus erythematous. All patients were treated with systemic anticoagulation with heparin (initially with unfractionated heparin if clinically unstable and later changed to low molecular weight heparin). We report a cluster of adolescents with unusual thrombotic complications with antiphospholipid antibody positivity during the coronavirus 19 pandemic, 3 with positive virologic criteria, one with delayed presentation after MIS-C like features and one with close family member exposure. We hypothesize that VTE in children is likely due to development of antiphospholipid antibodies when associated with SARS-CoV-2 infection. [Figure: see text] DISCLOSURES: No relevant conflicts of interest to declare. American Society of Hematology 2020-11-05 2021-08-03 /pmc/articles/PMC8330222/ http://dx.doi.org/10.1182/blood-2020-142964 Text en Copyright © 2020 American Society of Hematology. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle 322.Disorders of Coagulation or Fibrinolysis
Narang, Shalu
Morparia, Kavita
Sharma, Prachi
Venous Thromboembolic Disease in Children Associated with COVID-19
title Venous Thromboembolic Disease in Children Associated with COVID-19
title_full Venous Thromboembolic Disease in Children Associated with COVID-19
title_fullStr Venous Thromboembolic Disease in Children Associated with COVID-19
title_full_unstemmed Venous Thromboembolic Disease in Children Associated with COVID-19
title_short Venous Thromboembolic Disease in Children Associated with COVID-19
title_sort venous thromboembolic disease in children associated with covid-19
topic 322.Disorders of Coagulation or Fibrinolysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330222/
http://dx.doi.org/10.1182/blood-2020-142964
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