RESUMO
OBJECTIVE: We present four cases of lupus anticoagulant (AL) in children. In addition, as a result of the lack of literature published on the subject in our country. We also evaluate the epidemiological, clinical and prognostic characteristics of AL in children. PATIENTS AND METHODS: The diagnostic criteria established by the "Subcommittee for the Standardization of Lupus Anticoagulant" were followed. RESULTS: Over a ten-year period (1988-1998), 46 cases of children with TTPA prolongation were documented. Nine children showed circulating anticoagulant, 4 of which were lupus type anticoagulants. The age of the patients ranged from 4 to 13 and there was a prevalence of males (3/4). Half of the children had a family history of bleeding dyscrasia and it was these who showed hemorrhage or thrombotic symptoms. The case that started with ecchymosis and hemorrhaging showed prothrombin prolongation due to factor II deficit. In 3 of the 4 children, AL was linked to acute respiratory infections and was transitory. The other coincided with two thrombotic episodes of the lower extremities in a healthy child. Positive anticardiolipin antibodies were detected in two patients, both showing repeated AL episodes, one with thrombosis and the other always asymptomatic. CONCLUSIONS: Diagnosis of AL in children is difficult and has probably been underestimated. Although it is usually transitory, it can appear in repeated episodes. Its early detection is important as it can be linked to both prothrombin deficit, as well as significant symptoms of hemorrhaging.
