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Thromboembolic diseases of childhood
1Division of Hematology/Oncology, Pediatric Thrombosis and Haemostasis Program, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Ont., Canada M5G IX8.
Insights
Pediatric thrombophilia programs are advancing the diagnosis, prevention, and treatment of blood clots in children. Further research is needed to fully understand risk factors, diagnostic tests, and optimal antithrombotic therapies for pediatric thromboembolic events (TEs).
Area of Science:
- Pediatric Hematology
- Thrombosis Research
Background:
- Pediatric thrombophilia programs have become a distinct subspecialty.
- These programs address both venous and arterial thromboembolic events (TEs) in children.
- Previous reviews highlighted the need for specialized pediatric care.
Purpose of the Study:
- To update knowledge on pediatric thromboembolic events (TEs).
- To focus on risk factors, diagnostic tests, and antithrombotic agents for pediatric TEs.
- To identify areas requiring further research.
Main Methods:
- Review of existing literature and previous studies.
- Concentration on three key aspects: risk factors, diagnostic methods, and antithrombotic agents.
- Synthesis of current knowledge in pediatric thrombophilia.
Main Results:
- Current understanding of pediatric TEs is limited.
- Identified key areas for investigation: risk factors, diagnostic strategies, and therapeutic interventions.
- Highlighted the need for prospective trials.
Conclusions:
- Pediatric thrombophilia is an evolving field.
- There is a critical need for well-designed prospective trials.
- Further research is essential to optimize the diagnosis, prevention, and treatment of TEs in children.
Abstract:
Over the last decade, pediatric thrombophilia programs have emerged around the world as a new discipline in pediatric hematology. These programs specialize in the diagnosis, prevention and treatment of children with thromboembolic events (TEs) in both the venous and arterial systems. The need for separate pediatric programs has been discussed previously. (J Pediatr Hematol Oncol 1997; 19: 7-22.) The following article will update previous reviews (Hematol Oncol Clin North Am 1998; 12: 1283-1312; Thromb Haemost 1997; 78: 715-725) and will concentrate on three aspects: (1) The risk factors for acquiring TEs; (2) The confirmatory diagnostic tests used in children with TEs; and (3) The different antithrombotic agents used for prevention and treatment. The current knowledge in respect to the above points is only the "tip of the iceberg". Well-designed prospective trials are required to establish the contribution of congenital prothrombotic disorders, appropriate diagnostic strategies, and optimal therapy for children with TEs.