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Risk factors for thrombosis in Serbian children
Olivera M Serbic-Nonkovic1, Milos B Kuzmanovic, Ljiljana B Rakicevic
1aPediatric Clinic, Mother and Child Health Institute, 'Dr Vukan Cupic' bUniversity of Belgrade Institute of Molecular Genetics and Genetic Engineering cUniversity of Belgrade School of Medicine, Belgrade, Serbia.
Insights
Pediatric thrombosis is multifactorial, with inherited factors like Factor V Leiden and lupus anticoagulant antibodies increasing risk. Underlying medical conditions (comorbidity) are strongly associated with both venous and arterial thrombosis in children.
Area of Science:
- Pediatric Hematology
- Thrombosis Research
- Genetics
Background:
- Venous and arterial thromboses are recognized as significant health issues in pediatric patients.
- Understanding the risk factors for thrombosis in children is crucial for effective prevention and management.
Purpose of the Study:
- To investigate the role of inherited thrombophilic risk factors and comorbidity in pediatric thrombosis.
- To determine the independent risk factors contributing to venous and arterial thrombosis in children.
Main Methods:
- A case-control study was conducted involving 129 pediatric patients (from neonates to 18 years old).
- Analysis included inherited and acquired risk factors, thrombophilic profiles, and comorbidities.
- Statistical methods were used to identify independent risk factors and their associations with thrombosis.
Main Results:
- 87.2% of children had recognized thrombophilic and/or comorbid risk factors.
- Independent risk factors identified were Factor V Leiden mutation, lupus anticoagulant antibodies, and comorbidity.
- Factor V Leiden mutation was a risk factor for venous thrombosis (OR, 6.2). Lupus anticoagulant antibodies were linked to both venous and arterial thrombosis.
- Comorbidity was strongly associated with both venous (OR, 18.6) and arterial thrombosis (OR, 10.5).
Conclusions:
- Pediatric thrombosis is a multifactorial disorder.
- Comorbidity is a major contributing factor to thrombosis in children.
- Inherited thrombophilic disorders play a role in the development of thrombosis in the pediatric population.
Abstract:
Venous and arterial thromboses are increasingly encountered in the pediatric population. We present results of a case-control study of inherited and acquired risk factors for thrombosis in 129 pediatric patients from the first day of life to 18 years. The aims of study were to determine the importance of thrombophilic risk factors and comorbidity as a cause of thrombosis in children. Single thrombophilic risk factor was found in 24.4% (n = 21), whereas combined thrombophilic factors were found in 15.1% (n = 13) patients. A total of 87.2% of the children had recognized thrombophilic risk factors for thrombosis and/or additional comorbid risk factors. The single independent risk factors for thrombosis were mutation of factor V Leiden (P = 0.021), lupus anticoagulant antibodies (P = 0.028), and comorbidity (P = 0.000). Mutation of factor V Leiden [odds ratio (OR), 6.2 (95% confidence interval, CI 1.1-38.1, P = 0.048] was found to be a risk factor for venous thrombosis. Lupus anticoagulant antibodies were related to both venous (P = 0.008) and arterial thrombosis (P = 0.016). The frequency of inherited thrombophilic factors were the same in neonates and adolescents (23%). The prothrombotic gene mutations were present in 18.6% (n = 8) of asymptomatic children. Our study confirms that thrombosis in children is a multifactorial disorder, and associated most with the underlying medical disease (comorbidity) for vein thrombosis [OR, 18.6 (95% CI 3.7-93.4), P = 0.000] and for arterial thrombosis [OR, 10.5 (95% CI 2.2-49.9) P = 0.003]. Inherited thrombophilic disorders contributed to the development of thrombosis in children.
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