Prevalence of Antiphospholipid and Antinuclear Antibodies in Children with Epilepsy

Constantin, Tamás and Kálovics, Tamás and Ponyi, Andrea and Nagy, E. and Sallai, K. and Szabó, Léna and Garami, Miklós and Müller, Judit and Gergely, Péter and Dankó, Katalin and Fekete, György and Kálmánchey, Rozália (2009) Prevalence of Antiphospholipid and Antinuclear Antibodies in Children with Epilepsy. MEDICAL SCIENCE MONITOR-INTERNATIONAL MEDICAL JOURNAL FOR EXPERIMENTAL AND CLINICAL RESEARCH, 15 (4). CR164-CR169. ISSN 1234-1010

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Abstract

Background: Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by recurrent venous thrombosis or arterial occlusive events and fetal losses associated with elevated levels of antiphospholipid antibodies (aPLs). Material/Methods: The presence of antinuclear, anti-beta 2-glycoprotein I, and anticardiolipin antibodies were investigated in 60 consecutive children with epilepsy who were followed up in a single Hungarian center. Results: Almost 50% (28/60) of the patients were ANA positive. Twelve (20%) patients had moderate titer (1:160) of ANA. Anti-Clq antibody was positive in 4 cases, all of them symptom free considerating renal manifestations of lupus. Interestingly, only 1 child had aCL antibody, while 6/43 patients were LAC positive. Five were also ANA positive among the LAC positive patients (4 children with moderate titer). Anti-beta 2GPI antibody positivity was not detected in this cohort of patients. Conclusions: The clinical relevance of aPL tests in childhood are difficult to explain. In the present study, obviously lower total prevalence of aPLs (aCL and anti-beta 2GPI) was observed in children with epilepsy than in previously reported investigations (20-30%). The higher amount of LAC-positive patients indicates that coagulation studies (LAC) should be included in the neuroimmunological assessment of suspected APS patients with epilectic disorders. The difference between the results of serological and LAC studies could be explained by the possible positivity positivity of other, uninvestigated antibodies. The wide spectrum of detected immunological alterations highlight the importance of the participation of pediatric rheumatologists in the management of patients with idiopathic epilepsy or with secondary induced autoimmune disease due to antiepileptic medications .

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