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Venous thromboembolism
1Michigan State University, Clinical Centre, East Lansing 48824-1313, USA. gera@pilot.msu.edu
Insights
Pediatric venous thromboembolism (VTE) is increasing, often linked to central venous lines (CVLs). Early detection and management, considering genetic factors, are crucial for better outcomes in children with VTE.
Area of Science:
- Pediatric Hematology
- Vascular Medicine
- Thrombosis Research
Background:
- The incidence of venous thromboembolism (VTE) in children is rising.
- Increased use of central venous lines (CVLs) and improved diagnostic imaging contribute to higher VTE detection rates.
- Congenital prethrombotic disorders are increasingly recognized as risk factors for pediatric thrombosis.
Purpose of the Study:
- To discuss the clinical presentation, pathogenesis, and management of VTE in children.
- To highlight the role of central venous lines (CVLs) in the rising incidence of pediatric VTE.
- To emphasize the importance of identifying children at higher risk due to congenital prethrombotic disorders.
Main Methods:
- Review of clinical presentation and pathogenesis of pediatric VTE.
- Discussion of diagnostic modalities including ultrasound, lineogram, and venogram.
- Overview of current treatment strategies for pediatric VTE.
Main Results:
- Pediatric VTE incidence is increasing, associated with CVL use.
- Advanced imaging techniques enhance VTE detection in children.
- Congenital prethrombotic disorders play a significant role in pediatric thrombosis risk.
Conclusions:
- Effective management of pediatric VTE requires a comprehensive approach.
- Anticoagulation therapies (heparin, LMWH, warfarin) and thrombolytic therapy are key treatment options.
- Understanding pathogenesis, including genetic predispositions, is vital for managing pediatric VTE.
Abstract:
Incidence of venous thromboembolism (VTE) in children is rapidly rising. Frequent use of central venous lines (CVLs) in children with a variety of disease processes has contributed to increased incidence of VTE. In addition, increased detection of VTE has been possible due to the availability of sensitive imaging studies such as Color Duplex/Doppler ultrasound, lineogram and venogram. Heightened awareness of congenital prethrombotic disorders may help identify children at higher risk of thrombosis. Anticoagulation with heparin, low molecular weight heparin (LMWH) and oral anticoagulant such as warfarin are used for the treatment of VTE. Thrombolytic therapy may be indicated in some cases. Clinical presentation, management and pathogenesis including role of congenital prethrombotic disorders in pediatric VTE are discussed.