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Fibrinolytic parameters in children with noncatheter thrombosis: a pilot study

O Alphan Kupesiz1, Meera B Chitlur, Wendy Hollon

  • 1Department of Pediatrics, Akdeniz University School of Medicine, Antalya, Turkey.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|March 23, 2010
PubMed

Insights

Pediatric noncatheter-related deep venous thrombosis (nCDVT) is rare but linked to hypercoagulable states. This study found decreased fibrinolysis in children with nCDVT, suggesting hypofibrinolysis plays a key role.

Area of Science:

  • Pediatric Hematology
  • Thrombosis Research
  • Hemostasis and Thrombosis

Background:

  • Pediatric thrombosis incidence is rising, with noncatheter-related deep venous thrombosis (nCDVT) being uncommon in children.
  • Hypercoagulable states, both congenital and acquired, are suspected contributors to nCDVT pathogenesis.

Purpose of the Study:

  • To investigate the role of fibrinolytic parameters in pediatric nCDVT.
  • To compare fibrinolytic protein concentrations and thromboelastography findings between children with nCDVT and healthy controls.

Main Methods:

  • Measurement of individual fibrinolytic protein concentrations (TAFI, PAI-1, tPA, lipoprotein (a)).
  • Tissue factor-initiated whole blood thromboelastography (TEG) to assess clot lysis with added tissue plasminogen activator (tPA).
  • Comparison of pediatric nCDVT patients with age- and sex-matched controls.

Main Results:

  • Significantly elevated Thrombin-Activatable Fibrinolysis Inhibitor (TAFI) concentrations were observed in the nCDVT patient group.
  • No significant differences were found in Plasminogen Activator Inhibitor-1 (PAI-1), tissue plasminogen activator (tPA), or lipoprotein (a) levels.
  • Thromboelastography revealed significantly reduced fibrinolysis in children with nCDVT, indicating hypofibrinolysis.

Conclusions:

  • Hypofibrinolysis appears to be a significant factor in the pathogenesis of nCDVT in children.
  • This is the first pediatric study to systematically assess fibrinolysis's role in DVT.
  • Larger studies are warranted to further elucidate the role of fibrinolysis in pediatric nCDVT.

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