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The fibrinolytic system in children

Manuela Albisetti1

  • 1Division of Hematology, University Children's Hospital Zurich, Switzerland. manuela.albisetti@kispi.unizh.ch

Seminars in Thrombosis and Hemostasis
|October 1, 2003
PubMed

Insights

Pediatric fibrinolysis differs from adult levels, impacting thrombolytic therapy effectiveness and safety. Understanding these developmental changes is crucial for treating childhood thrombotic diseases.

Area of Science:

  • Biochemistry
  • Pediatrics
  • Hematology

Background:

  • The fibrinolytic system dissolves blood clots.
  • Key fibrinolytic components have different concentrations in children than adults.
  • Fibrinolytic activity is lower in newborns and children compared to adults.

Purpose of the Study:

  • To discuss the ontogenic features of the pediatric fibrinolytic system.
  • To summarize the effect of developmental fibrinolysis on disease and thrombolytic therapy in children.

Main Methods:

  • Review of existing literature on pediatric fibrinolysis.
  • Analysis of age-dependent differences in fibrinolytic components.
  • Evaluation of the impact on disease pathogenesis and treatment.

Main Results:

  • Plasma levels of plasminogen and alpha (2)-antiplasmin are lower in infants up to 6 months.
  • Tissue-type plasminogen activator levels are decreased, while plasminogen activator inhibitor-1 levels are increased in children.
  • Newborns and children exhibit reduced plasmin generation and overall fibrinolytic activity.

Conclusions:

  • Age-dependent variations in the fibrinolytic system significantly affect thrombolytic agent efficacy and safety in children.
  • Impaired fibrinolysis in children may contribute to venous/arterial diseases and vasculitis.
  • Understanding developmental fibrinolysis is essential for managing pediatric thrombotic conditions and guiding therapy.

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