Antiphospholipid Syndrome in Pediatric SLE Patients: Clinical Manifestations and Risk Factors

Thrombotic Manifestations

Deep vein thrombosis is the most common thrombotic manifestation in APS, particularly in pediatric patients with SLE, according to the American College of Rheumatology 1
Ischemic stroke and transient ischemic attacks (TIA) comprise over 80% of cerebrovascular disease cases in SLE-APS patients, as reported by the European League Against Rheumatism 1
Cerebrovascular disease commonly occurs (50-60%) in the context of high disease activity and persistently positive moderate-to-high titers of antiphospholipid antibodies, as stated by the American College of Rheumatology 1

Attention deficits, visual memory impairment, verbal memory problems, executive dysfunction, and reduced psychomotor speed are the most commonly affected cognitive domains in SLE-APS patients, according to the American Academy of Neurology 1
Cognitive dysfunction may benefit from anticoagulation therapy in APS patients, though evidence is limited, as reported by the American College of Rheumatology 3
Generalized tonic-clonic seizures occur in 67-88% of SLE patients with seizure disorder, as stated by the International League Against Epilepsy 3

Normal laboratory values do not exclude active CNS lupus, as neurological involvement can occur independently of systemic disease activity, as warned by the American College of Rheumatology 2
The most dangerous error is attributing symptoms to lupus without adequately ruling out infection, particularly in immunosuppressed patients, as cautioned by the Infectious Diseases Society of America 4

Triple antibody positivity (lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein I) indicates the highest risk for thrombotic events, as reported by the American College of Cardiology 5
Persistently positive moderate-to-high titers of antiphospholipid antibodies represent strong risk factors for cerebrovascular disease, as stated by the American Heart Association 1