Presencia de anticuerpos antifosfolípidos en niños con fiebre y petequias

espanolIntroduccion: La presencia de un tiempo de cefalina (APTT) alargado en ninos con fiebre y petequias es un hallazgo descrito en la bibliografia. La causa de esta alteracion se desconoce, pero se postula que puede deberse a la formacion de anticuerpos antifosfolipidos (Ac AFL). El objetivo de este estudio es determinar si el alargamiento del APTT se asocia con la formacion Ac AFL. Pacientes y metodos: Estudio observacional, prospectivo, de casos y controles, realizado en ninos que consultaron por fiebre y petequias en el servicio de urgencias de un hospital de tercer nivel durante un periodo de 13 meses. Se recogieron variables epidemiologicas, clinicas y analiticas. Se describieron las caracteristicas de los grupos con APTT alargado y normal, y se comparo la asociacion entre las concentraciones de los diferentes anticuerpos y el APTT. Resultados: Se incluyeron 36 pacientes, 12 casos y 24 controles. No se encontraron diferencias significativas respecto a la positividad de Ac AFL entre los casos y los controles (odds ratio [OR]= 1,67; intervalo de confianza [IC] del 95%: 0,31-9,04). No se observo ninguna asociacion entre los diferentes tipos de anticuerpos y el APTT, cuyos coeficientes de regresion fueron de 0,04 seg (IC del 95%: –0,31 a 0,40) para anticardiolipina IgG, de 1,11 seg (IC del 95%: –1,24 a 3,46) para la IgM, y de –0,02 seg (IC del 95%: –0,35 a 0,31) y 0,64 seg (IC del 95%: –1,40 a 2,68) para antibeta 2 GPI, IgG e IgM, respectivamente. Conclusion: Ante los resultados de nuestro estudio, no podemos concluir que el alargamiento de APTT se relacione con la presencia de Ac AFL. EnglishIntroduction: The presence of a longer time of cephalin (APTT) extended in children who come to emergency department with fever and petechiae is a result previously described in the literature. The cause of this alteration in coagulation is unknown, it is presumed that may be due to the formation of antiphospholipids antibodies. The aim of this study is to determine if the length of APTT is associated to the formation of antiphospholipids antibodies. Patients and methods: Observational, prospective case-control study in children who consulted for fever and petechiae in the emergency department of a tertiary hospital over a 13-month period epidemiological; clinical and laboratory variables were collected. The characteristics of groups with elongated and normal APTT were described and the association between concentrations of different antibodies and APTT were compared. Results: 36 patients, 12 cases and 24 controls, were included. No significant differences were found regarding the positivity of antiphospholipid antibodies between cases and controls (OR= 1.67; 95%CI: 0.31 to 9.04). No association was observed between the different types of antibodies and APTT, resulting regression coefficients in 0.04 s (95%CI: –0.31 to 0.40) for cardiolipin IgG, 1.11 s (95%CI: –1.24 to 3.46) for IgM and –0.02 s (95%CI: –0.35 to 0.31) and 0,64 s (95%CI: –1.40 to 2.68) for antibeta 2 GPI, IgG and IgM, respectively. Conclusion: Given the results of our study we can not conclude that the elongation of APTT is related with the presence of antiphospholipids antibodies.