Recombinant plasminogen activator therapy for cerebral vein thrombosis in a child carrier of prothrombin gene...

Area of Science:

• Pediatric Neurology
• Hematology
• Thrombosis Research

Background:

• Cerebral venous sinus thrombosis (CVST) is a rare but serious condition in children.
• Genetic factors, such as the G20210A prothrombin gene mutation, can increase the risk of thrombosis.
• Early diagnosis and effective treatment are crucial for favorable outcomes in pediatric CVST.

Observation:

• A 3-year-old child presented with symptoms of transverse and sigmoid sinus venous thrombosis.
• The child was identified as a carrier of the G20210A prothrombin gene mutation.
• Neurologic signs appeared 9 days prior to the initiation of treatment.

Findings:

• Recombinant tissue plasminogen activator (rt-PA) therapy was administered 9 days after the onset of neurologic symptoms.
• The rt-PA treatment lasted for 9 days.
• Complete dissolution of the transverse and sigmoid sinus thrombus was achieved with rt-PA therapy.

Implications:

• This case highlights the potential utility and safety of rt-PA for treating CVST in pediatric patients.
• The findings support the consideration of rt-PA in managing complex thrombotic events in children, particularly those with underlying genetic predispositions.
• Further research into rt-PA's role in pediatric thrombosis is warranted to establish definitive treatment guidelines.