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Prothrombotic factors in children with stroke or porencephaly

John Kylan Lynch1, Christina J Han, Linda E Nee

  • 1National Institute of Neurological Disorders and Stroke, Building 10, Room 5S220, 10 Center Dr, MSC 1447, Bethesda, MD 20892-1447, USA. lynchj@ninds.nih.gov

Pediatrics
|August 3, 2005
PubMed

Insights

In children with arterial ischemic stroke or porencephaly, two-thirds had at least one prothrombotic risk factor. Several children exhibited multiple risk factors, indicating commonality of these abnormalities.

Area of Science:

  • Pediatric Neurology
  • Hematology
  • Genetics

Background:

  • Arterial ischemic stroke (AIS) and porencephaly in children are serious conditions.
  • Understanding the underlying causes, particularly prothrombotic abnormalities, is crucial for diagnosis and management.

Purpose of the Study:

  • To compare the frequencies of genetic and functional coagulation abnormalities in children with AIS or porencephaly.
  • To assess the prevalence of specific prothrombotic risk factors in this pediatric population.

Main Methods:

  • A cohort of 59 children (age 0-18 years) with AIS or porencephaly underwent comprehensive blood analysis.
  • Tests included screening for protein C, protein S, antithrombin deficiencies, activated PC resistance, lipoprotein (a), lupus anticoagulant, anticardiolipin antibodies, and specific gene mutations (MTHFR, Factor V, Factor II, PAI-1, TFPI).
  • Frequencies were compared with published international pediatric stroke data.

Main Results:

  • At least one prothrombotic abnormality was identified in 63% of the studied children.
  • Common abnormalities included PAI-1 mutation, MTHFR mutation, elevated Lp(a), and APCR.
  • Rates of MTHFR mutation, elevated Lp(a), PT mutation, and AT deficiency were similar to reported AIS cases, while APCR and multiple abnormalities were higher than previously reported.

Conclusions:

  • A significant proportion (two-thirds) of children with AIS or porencephaly presented with at least one prothrombotic risk factor.
  • The findings underscore the high prevalence of prothrombotic abnormalities in children diagnosed with AIS or porencephaly.
  • Further investigation into these risk factors may aid in personalized treatment strategies for pediatric stroke.
Abstract

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