Related Experiment Videos
[Thromboembolic complications in pediatric orthopedics. Multicentric collection of 33 case reports]
G Norotte1, C Glorion, J Conard
1Service d'Orthopédie Pédiatrique, Hôpital Necker Enfants-Malades, Paris.
Insights
Pediatric venous thrombosis, often in the iliac or femoral veins, can lead to acute complications and post-phlebitic sequelae. Identifying congenital hemostasis disorders is crucial for effective treatment and prognosis in children.
Area of Science:
- Pediatric vascular medicine
- Hematology
- Clinical case series
Context:
- Venous thromboembolism (VTE) in children is less common than in adults.
- Limb deep vein thrombosis (DVT) presents unique diagnostic and management challenges in pediatric populations.
- Understanding risk factors and outcomes is vital for improving pediatric VTE care.
Purpose:
- To analyze the clinical characteristics, complications, and sequelae of limb venous thrombosis in children.
- To evaluate the role of congenital hemostasis disorders in pediatric VTE.
- To identify potential risk factors for developing venous thrombosis in pediatric patients.
Summary:
- This study reviewed 33 pediatric cases of limb venous thrombosis (age ≤ 15 years), with thrombi predominantly in iliac/femoral veins.
- 22 cases of acute thrombophlebitis were treated, and 11 presented with post-phlebitic disease; 30% experienced acute complications, and 25% of treated children had sequelae.
- Congenital hemostasis disorders (antithrombin III, protein C, or S deficiency) require detection before anticoagulation due to treatment and prognostic implications.
Impact:
- Highlights the significant risk of acute complications and long-term sequelae in pediatric limb venous thrombosis.
- Emphasizes the necessity of screening for congenital hemostasis disorders in affected children.
- Identifies a high-risk pediatric population for venous thrombosis, including those with a history of VTE, parental VTE, thrombogenic conditions, or vertebral arthrodesis.
Abstract:
We report 33 cases of venous thrombosis of the limb, in children aged 15 years or less (average age is 10 years old): 22 acute thrombophlebitis have been treated, 11 children shown post-phlebitic disease. The thrombus was found, most of the time, in the iliac and/or femoral vein. Acute complications were seen in 30% of our cases, and 25% treated children reviewed, had post-phlebitic sequelae. Congenital disease of hemostasis (deficiency of antithrombin III, protein C or S) must be detect before anticoagulant start, because such deficiency influence the treatment and the prognosis. There is non indication for preventive treatment, because of the rarity of spontaneous thrombophlebitis by children. Nevertheless, we can draw an "high risk" population: antecedent of phlebitis, antecedent of congenital disease of hemostasis, antecedent of thrombophlebitis by parents below 40 years old, thrombogenic disease (homocystinuria), vertebral arthrodesis.