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Cerebral infarction and antiphospholipid syndrome in children.

J Rheumatol

August 1996

Department of Immunology, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, Mexico City, Mexico.

Objective: To investigate the prevalence of antiphospholipid antibodies (aPL) in children with acute cerebral infarction.

Methods: The study was carried out in 10 consecutive patients during the first days of neurological symptoms. aPL detected as lupus anticoagulant or anticardiolipin antibodies (aCL) and natural anticoagulant proteins C, S, and antithrombin III were determined in all patients.

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Antithrombin III (AT III) determinations were done in healthy and sick horses using the chromogenic substrate Chromozym TH. Reference values for adult horses at 25 degrees C were 18-25 IU AT III per ml plasma and 84-118% AT III activity of normal horse plasma, respectively. Precision and accuracy were good (intra assay coefficient of variation less than 2%, accuracy 10%).

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To assess the value of the aminopyrine breath test (ABT) and antithrombin III (AT III) determinations in liver disease, both tests were performed on 77 consecutive patients who underwent liver biopsies for increased values of liver enzymes and in 20 patients with clinical cirrhosis. The mean values of AT III and ABT were significantly lower in cases of liver cirrhosis than in cases of steatosis and steatofibrosis. The AT III and ABT values were abnormal in, respectively, 83.

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Assays for antithrombin III activity using the chromogenic substrate S-2238 were automated in various modifications on various instruments. Standard curves for the assay showed a deviating "0% point" in several but not all modifications. Addition of polyethylene glycol 6000/8000 (0.

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The role of antithrombin-III with respect to atherogenesis and myocardial infarction remains unclear; however, it has been reported that antithrombin-III levels are decreased in many individuals with coronary artery disease and in those at high risk for coronary artery occlusion. However, the several reports available do not agree and remain inconclusive. Antithrombin-III levels were determined in 86 individuals undergoing coronary artery angiography.

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