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Pediatric reference values for molecular markers in hemostasis.

Darintr Sosothikul1, Panya Seksarn, Jeanne M Lusher

  • 1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Rama IV Road, Bangkok 10330, Thailand. dsosothikul@hotmail.com

Journal of Pediatric Hematology/Oncology
|January 19, 2007
PubMed
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Pediatric hemostasis differs from adults, with younger children showing higher soluble thrombomodulin, prothrombin time, tissue factor, thrombin-antithrombin complex, and D-dimer. These findings aid in diagnosing bleeding disorders in children.

Area of Science:

  • Pediatric Hematology
  • Hemostasis and Thrombosis
  • Clinical Coagulation

Background:

  • The hemostatic system undergoes significant age-related development and change.
  • Understanding these age-specific alterations is crucial for accurate clinical interpretation.

Purpose of the Study:

  • To delineate distinct hemostatic parameters between pediatric and adult populations.
  • To establish normative reference ranges for hemostatic markers across various pediatric age strata.

Main Methods:

  • Blood samples were collected from healthy children (1-18 years, n=70) and adults (n=26).
  • Children were stratified into three age cohorts: 1-5 years, 6-10 years, and 11-18 years.
  • Comprehensive analysis of coagulation and fibrinolysis markers was performed.

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Main Results:

  • No significant differences were observed in mean levels of von Willebrand factor, activated partial thromboplastin time, fibrinogen, activated factor VII, tissue plasminogen activator, plasminogen activator inhibitor-1, and thrombin activatable fibrinolysis inhibitor between children and adults.
  • Younger children (1-5 years) exhibited significantly higher mean values for soluble thrombomodulin, prothrombin time, tissue factor, thrombin-antithrombin complex, and D-dimer compared to adults.
  • Conversely, children aged 1-5 years demonstrated significantly lower mean protein C activity than adults.

Conclusions:

  • The study highlights inherent physiological variations in the hemostatic system between children and adults.
  • These findings provide a valuable reference for interpreting coagulation test results in pediatric patients, particularly those with suspected bleeding disorders.