Anti-cardiolipin Antibody and Coagulopathy in a Patient with Kawasaki Disease Complicated by Meningitis / 대한소아혈액종양학회지

ABSTRACT

Antiphospholipid antibodies are a family of autoantibodies directed against certain phospholipids or phospholipid-binding proteins. Antiphospholipid antibody syndrome can occur as a secondary event to an underlying autoimmune disease, most commonly systemic lupus erythematosus and also occur in certain infectious diseases and drug reactions. We experienced a patient with Kawasaki disease who had anticardiolipin antibodies accompanied by coagulation abnormalities. A 4-month-old female patient was admitted due to fever, irritability, lymph node swelling on the right submandibular area and maculopapular skin rashes on trunk and both extremities. She had prolonged activated partial thromboplastin time (aPTT). Further investigations revealed a positive anticardiolipin antibody detected by ELISA. She had right lateral sinus thrombosis on parieto-occipital area on brain MRI and thrombotic microangiopathy, resulting in necrosis of toe. She showed considerable improvement in affected skin after dexamethasone treatment for 3 weeks. Thrombosis was resolved completely 2 months later.