Haemorrhagic syndromes and positive lupus anticoagulant test

Key words: Positive lupus anticoagulant, Haemorrhagic syndromes, Hypothrombinaemia syndrome, Activated partial thromboplastin time

The paper reports the cases of two children who presented with a coagulation alteration with a clinically evident haemorrhagic diathesis. In one case the child presented with cutaneous purpura, in the other case with bleeding of the upper digestive tract, and both showed positive lupus anticoagulant (LAC) test results. A prolongation of activated partial thromboplastin time (aPTT) during a light haemorrhagic manifestation such as purpura associated with positive LAC test was observed in the first case. Although the prolongation of aPTT is the most frequent coagulation abnormality accidentally detected in children without clinical manifestations, it is instead worthwhile to remember that sometimes it is associated with light haemorrhagic manifestations just like in the above-described case. In the second case the performed lab tests confirmed the prolongation of aPTT together with a prolongation of prothrombin (PT) with positive LAC and consumption of Factor II and enabled to diagnose hypothrombinaemia syndrome induced by lupus anticoagulant (SIAL), whose development in the child was predominantly observed after an infective episode. This is a benign and transient condition, however it is important to recognise it because it can trigger a potentially serious symptomatology.