A 15-year-old patient with suspected antiphospholipid syndrom: a case report
Introduction (case reports only) Antiphospholipid syndrome (APS) is an autoimmune multisystem disorder characterized by arterial, venous, or small vessel thromboembolic events and/or pregnancy morbidity in the presence of persistent antiphospholipid antibodies (aPL). Main laboratory criteria for the diagnosis are the presence of antiphospholipid antibodies on ≥2 occasions ≥12 weeks apart. To meet laboratory criteria, at least one persistently positive aPL must be present in moderate to high titers. Case description (case reports only) A 15-year-old male patient presented for a suspected antiphospholipid syndrome at the hospital of Lithuanian university of Health Sciences. He is a basketball player, has a diagnosis of Osgood-Schlatter disease, due to which he wears a compressing knee bandage. In June of 2022, the patient complained of pain in the left ankle, that resolved spontaneously. In September of 2022 he suffered a sudden pain, swelling and prominent veins in his left calf. Then patient was diagnosed with thrombosis of the left v. Saphena magna, and had high titers of anticardiolipin IgG and was treated with Aspirin. The condition has improved. Laboratory tests for antiphospholipid syndrome were repeated after 3 months and all antiphospholipid antibodies (anti-cardiolipin (IgM and IgG), anti-beta2 glycoprotein (IgM and IgG), lupus anticoagulant) and coagulation parameters were within the normal range. No specific treatment was prescribed Summary (case reports only) Tests have shown that superficial venous thrombosis for this patient was not caused by antiphospholipid syndrome. Mechanical pressure (compressing knee bandage) may have been the possible cause, but it is important to repeat the tests again if the thrombosis recurs for the patient. Conclusions Superficial venous thromboses can be caused not only by antiphospholipid syndrome, but should always be investigated if antiphospholipid antibodies are present. For the patients with recurrent thromboses it is very important timely diagnostic as well as to prevent future thromboses and long-term anticoagulation is sometimes necessary.