Lupus anticoagulant hypoprothrombinemia syndrome associated with severe thrombocytopenia in a child

Pediatr Blood Cancer. 2017 Jun;64(6). doi: 10.1002/pbc.26357. Epub 2016 Nov 15.

Abstract

Lupus anticoagulant hypoprothrombinemia syndrome (LAHPS) comprises lupus anticoagulant, acquired hypoprothrombinemia, and often mild thrombocytopenia or normal platelets. It is usually associated with autoimmunity or postviral illness. We describe a case of a 10-year-old boy with oral bleeding and severe thrombocytopenia initially suggestive of immune thrombocytopenia. Secondary to bleeding, evaluation demonstrated prolonged coagulation tests and subsequently revealed the presence of lupus anticoagulant and hypoprothrombinemia, along with marked autoimmunity, suggestive of LAHPS. He was treated with intravenous immunoglobulin and hydroxychloroquine. This case report and discussion highlight the diagnostic and therapeutic challenges associated with LAHPS and coincident severe thrombocytopenia.

Keywords: hypoprothrombinemia; lupus coagulation inhibitor; pediatrics; thrombocytopenia.

Publication types

  • Case Reports

MeSH terms

  • Autoimmune Diseases* / blood
  • Autoimmune Diseases* / complications
  • Autoimmune Diseases* / therapy
  • Child
  • Humans
  • Hypoprothrombinemias* / blood
  • Hypoprothrombinemias* / complications
  • Hypoprothrombinemias* / therapy
  • Lupus Coagulation Inhibitor / blood*
  • Male
  • Oral Hemorrhage* / blood
  • Oral Hemorrhage* / etiology
  • Oral Hemorrhage* / therapy
  • Severity of Illness Index
  • Syndrome
  • Thrombocytopenia* / blood
  • Thrombocytopenia* / etiology
  • Thrombocytopenia* / therapy

Substances

  • Lupus Coagulation Inhibitor