SynthesisFrontiers in immunology2026
Pentasystem embolism associated with transient antiphospholipid antibodies in severe M.
Synthesis in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Background: Thromboembolism is a critical complication of severe Methods: We report a case of extensive multi-system thrombosis in a 6-year-old boy with SMPP. A systematic review of literature (January 2020-December 2025) identified 19 studies comprising 199 pediatric cases. Results: In the index case, thrombosis coincided with hyperinflammation and transient aPLs, which seroconverted to negative upon recovery. Pooled analysis showed multi-system involvement in 27.1% of cases (54/199). Among tested patients (n = 65; 32.7% of the cohort), aPL positivity was 69.2% (45/65). Most patients achieved favorable outcomes with anticoagulation and immunomodulation. Conclusion: This study is consistent with the "dual-hit" model in SMPP, where systemic inflammation may prime the endothelium and transient aPL positivity coincides with an extensive thrombotic burden. The high prevalence of multi-system involvement supports low-threshold vascular imaging and aPLs screening, along with biomarker-guided management. Transient aPLs should be interpreted as a potential risk-amplifying biomarker rather than a proven causal driver of thrombosis.
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