|
MULTICENTRE
STUDIES
REGISTER OF INFANTS WITH FETAL OR PERINATAL
THROMBOSIS BORN TO MOTHERS HAVING ANTIPHOSPHOLIPID antibodies: A Proposal. Thrombosis in babies allowing detection of
antiphospholipid antibodies in mothers
COORDINATORS
Boffa MC 1, Lachassinne
E2, Avcin T3, Aurousseau
MH2, Fain O2, Rai R4, Wollina U5, Mensah P6, Douard P7,
Farge-Bancel D8, Cervera
R9, Piette JC1,
Uzan M2 , Regan L4
1Hôpital
Pitié-Salpétrière 75013 Paris, France; 2Hôpital
Jean Verdier Bondy and Université Paris
XIII
Bobigny EA 3409, France; 3University Children’s Hospital,
Ljubjana, Slovenia; 4Imperial College
London, St Mary's
Hospital, London, UK; 5Hospital
Dresden-Friedrichstadt, Dresden, Germany; 6University of Leicester Hospitals,
Leicester, UK; 7Pediatrics, CHR Senlis, France; 8Hôpital
Saint-Louis, Paris, France; 9Hospital Clinic,
08036-Barcelona, Catalonia, Spain.
PROJECT
Background: Obstetrical complications of the antiphospholipid syndrome (APS) are
well known but no risk of thrombosis were thought to be incurred by the offspring.
Between 1987 and 2000, 13 cases of neonatal thromboses related to
antiphospholipid antibodies (APLA) in the mother have been published. Thomboses
were mostly arterial (10/13 times) of which 6 were in the cerebral territory,
two venous, and one both arterial and venous. Lupus anticoagulant (LA) and/or
anticardiolipin antibodies (ACLA) were present in all mothers. In the infants
LA and/or ACLA were present in 8, absent in one and not detected in 4 cases.
We recently
observed a case of cerebral artery thrombosis in a 10-month old baby born to a
mother with lupus and APLA. Questioning few pediatricians or obstetricians
around us, we were able to trace more cases of thromboses: perinatal cerebral
thrombosis, fetal hepatic vein thrombosis, axillary vein and digital
thromboses. Interestingly, in most of the cases, the presence of APLA was
discovered in the mother only after their infant’s thrombosis. Progressively,
new cases appeared, prompting us to start this register.
Objectives: These
observations suggest that, although rare, perinatal thromboses are not as
exceptional as previously thought. We therefore propose a prospective Euro-APL
Forum register extended to International data collection. It would be an
internet-based, freely consulted register. It would allow to better evaluate
the prevalence of perinatal thrombosis, its relationship with the mother
autoimmune status, pregnancy treatment, thrombotic history, with the presence
of aPLA in the infant.
Inclusions: Could
be included any live-born infant born to a mother with APLA (detected before or
after the baby thrombosis) in whom a thrombosis (arterial, venous,
microvascular) was detected and confirmed. Will be included thrombosis detected
during the pregnancy up to the baby walking age.
Data collection: within
5 tables: 1/ the baby thrombotic and general history, type and localisation of
the thrombosis, clinical symptoms and imaging 2/ the mother obstetrical history
with pregnancy course and treatment, previous obstetrical symptoms. 3/ the
maternal and familial history in regards to autoimmune disease and
thrombophilic factors. 4/ Laboratory findings will include platelet count and
D-Dmer of the baby and for both mother and child: the different APLA, other
antibodies if present, any thrombophilic congenital factor. 5/ the authors with
the case number, the case reporter with
publication or address (postal and e-mail) and associated subspecialists
involved in the case.
For additional
information and applications, please e-mail: marie-claire.boffa@psl.ap-hop-paris.fr
For review of the
already collected data, please click:
|
Web contens: EWPSLE Info Desk. |
|
|
Last updated: 21 January 2006 |
|