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The fibrinolytic system in children
1Division of Hematology, University Children's Hospital Zurich, Switzerland. manuela.albisetti@kispi.unizh.ch
Seminars in Thrombosis and Hemostasis
|October 1, 2003
Summary
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.