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Pediatric reference intervals for uncommon bleeding and thrombotic disorders

Michele M Flanders1, Amit R Phansalkar, Ronda A Crist

  • 1ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah, USA.

The Journal of Pediatrics
|August 5, 2006
PubMed

Insights

This study establishes pediatric reference intervals for key blood clotting factors and proteins in children aged 7-17. Results show these factors change with age during adolescence, differing from adult levels.

Area of Science:

  • Pediatric Hematology
  • Hemostasis and Thrombosis Research

Background:

  • Accurate reference intervals are crucial for diagnosing hemostatic disorders in children.
  • Existing pediatric data for many coagulation factors and inhibitors are limited, especially for older children.

Purpose of the Study:

  • To establish pediatric reference intervals and median values for specific hemostasis analytes in children aged 7 to 17 years.
  • To investigate the age-related changes of these analytes during late childhood and adolescence.

Main Methods:

  • Analysis of blood samples from a cohort of children aged 7 to 17 years.
  • Measurement of coagulation factors (II, V, VII, X), fibrinogen, and natural anticoagulants/fibrinolytic proteins (alpha-2-antiplasmin, antithrombin, plasminogen, protein C, protein S).
  • Statistical analysis to determine reference intervals and assess age-dependent trends compared to adult values.

Main Results:

  • Pediatric reference intervals and median values were determined for factors II, V, VII, X, fibrinogen, alpha-2-antiplasmin (AP), antithrombin (AT), plasminogen, protein C (PC), and protein S (PS).
  • Significant age-dependent variations were observed for most analytes in children aged 7-17.
  • Median values showed trends that differed from established adult reference ranges.

Conclusions:

  • This study provides essential pediatric reference data for hemostasis analytes in older children and adolescents.
  • The findings highlight the importance of age-specific reference intervals for accurate clinical interpretation in pediatric populations.
  • Age-dependent changes underscore the ongoing maturation of the hemostatic system throughout adolescence.

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