Related Experiment Video

Updated: May 25, 2026

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well
08:01

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

Published on: February 27, 2026

Reference values for thrombotic markers in children

Darintr Sosothikul1, Yaowaree Kittikalayawong, Pattramon Aungbamnet

  • 1Hematology and Oncology Division, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. dsosothikul@hotmail.com

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|February 11, 2012
PubMed

Insights

Pediatric thrombotic disorders require age-specific lab tests. This study establishes reference ranges for key hemostatic parameters in children, revealing significant differences from adults to aid diagnosis.

Area of Science:

  • Pediatric Hematology
  • Thrombosis and Hemostasis Research
  • Clinical Diagnostics

Background:

  • Thromboembolic events are a growing concern in pediatric populations.
  • Laboratory diagnosis of pediatric thrombotic disorders differs from adult protocols.
  • Establishing age-specific reference ranges for hemostatic parameters is crucial for accurate diagnosis.

Purpose of the Study:

  • To determine normal reference values for natural anticoagulant parameters in healthy children across different age groups.
  • To compare these pediatric reference values with adult values for key hemostatic factors.
  • To provide a diagnostic reference guide for physicians interpreting hemostatic tests in children with suspected thrombotic disorders.

Main Methods:

  • Plasma samples were collected from 127 healthy children (2 months to 16 years) and 30 adults.
  • Assays were performed for a disintegrin-like and metalloprotease with thrombospondin type 1 domain 13 (ADAMTS-13), von Willebrand factor collagen-binding activity (vWF:CB), tissue factor pathway inhibitor (TFPI), homocysteine, and natural anticoagulants.
  • Children were stratified into four age groups: <1 year, 1-5 years, 6-10 years, and 11-16 years.

Main Results:

  • Significantly lower reference values for ADAMTS-13, homocysteine, and protein C activity were observed in all pediatric age groups compared to adults.
  • Protein C antigen, total protein S, free protein S, and antithrombin III (AT III) were significantly lower in children under 1 year compared to adults.
  • Tissue factor pathway inhibitor (TFPI) levels were significantly higher in all pediatric age groups than in adults, while vWF:CB levels were comparable across all groups.

Conclusions:

  • Significant age-related physiological differences exist in ADAMTS-13, TFPI, homocysteine, and natural anticoagulant levels between children and adults.
  • These findings highlight the necessity of age-specific reference ranges for accurate interpretation of hemostatic parameters in pediatric patients.
  • The established reference data will serve as a valuable guide for clinicians diagnosing thrombotic disorders in children.

More Related Videos

A Microfluidic Flow Chamber Model for Platelet Transfusion and Hemostasis Measures Platelet Deposition and Fibrin Formation in Real-time09:38

A Microfluidic Flow Chamber Model for Platelet Transfusion and Hemostasis Measures Platelet Deposition and Fibrin Formation in Real-time

Published on: February 14, 2017

Related Concept Videos

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...