Severe Antiphospholipid Syndrome in a Child with Chicken Pox: Clinical Case
https://doi.org/10.15690/vsp.v23i4.2769
Abstract
Background. Antiphospholipid syndrome develops at autoimmune diseases, pregnancy, or genetic predisposition, and it is characterized by high risk of thrombosis in arterial, venous, and capillary vessels. This syndrome in children is rare, and necrotic skin lesions occur in the most extreme cases. Clinical case description. A child, 1 year old, with chicken pox has developed hemorrhagic rash on his back, swelling of the left shoulder and forearm on the 4th day of the disease. Medical treatment included acyclovir, ceftriaxone, sodium heparin. Aggravation of hemorrhagic rash over the body, spread of edema from the left shoulder to upper arm and neck, formation of flaccid bubble and necrosis locus (75 cm) on the outer upper third of the left shoulder were noted on the 5th-6th day. Increase in the levels of antibodies to 2-glycoprotein I (IgG — 48.9 U/ml, IgM — > 100 U/ml) and cardiolipin (IgM — 73.0 U/ml) was revealed. The diagnosis “antiphospholipid syndrome” was established. All necrotized tissues were removed on the 11th day, and the wound defect (86 cm) was subsequently covered by mesh skin grafts. The levels of antibodies (IgG + IgM) to 2-glycoprotein I remained high, 45.2 U/mL, 12 weeks after the onset of the disease. Thus, it has confirmed the development of antiphospholipid syndrome. The child continued treatment with warfarin (3.75 mg/day) with INR control. Conclusion. Hemorrhagic skin lesions in children with infectious diseases requires laboratory diagnostics of antiphospholipid syndrome, early prescription of anticoagulant and antiplatelet therapy, and surgical support.
About the Authors
Elena M. Kamaltynova
Regional Children’s Hospital ; Siberian State Medical University
Russian Federation
Disclosure of interest:
Russian Federation
Tomsk
Disclosure of interest:
Not declared.
Roman V. Bocharov
Regional Children’s Hospital ; Siberian State Medical University ; Emergency Hospital No.2
Russian Federation
Disclosure of interest:
Russian Federation
Tomsk
Disclosure of interest:
Not declared.
Vladimir G. Pogorelko
Siberian State Medical University ; Emergency Hospital No.2
Russian Federation
Disclosure of interest:
Russian Federation
Tomsk
Disclosure of interest:
Not declared.
Tatyana V. Zgerskay
G.E. Sibirtsev Children’s Infectious Diseases Hospital
Russian Federation
Disclosure of interest:
Russian Federation
Tomsk
Disclosure of interest:
Not declared.
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For citations:
Kamaltynova E.M., Bocharov R.V., Pogorelko V.G., Zgerskay T.V. Severe Antiphospholipid Syndrome in a Child with Chicken Pox: Clinical Case. Current Pediatrics. 2024;23(4):234-240. (In Russ.) https://doi.org/10.15690/vsp.v23i4.2769
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