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Rethinking thrombophilia testing in pediatric VTE: A decade of real-world evidence

Mahdi Asleh1, Hadeel Musa2, Shirly Ammar3

  • 1Pediatric Hemato-oncology Department, Saban Pediatric Medical Center, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Thrombosis Research
|December 27, 2025
PubMed

Insights

Routine thrombophilia testing in children with venous thromboembolism (VTE) did not change anticoagulation duration or predict recurrence. Selective testing is recommended over routine screening after a first VTE event.

Area of Science:

  • Pediatric Hematology
  • Thrombosis Research
  • Clinical Outcomes Analysis

Background:

  • The clinical value of routine thrombophilia testing in pediatric venous thromboembolism (VTE) management remains controversial.
  • This study aimed to assess the real-world impact of thrombophilia testing on treatment and patient outcomes.

Purpose of the Study:

  • To evaluate if thrombophilia testing influences anticoagulation duration in pediatric VTE patients.
  • To determine the association between thrombophilia status and VTE recurrence and thrombus resolution.

Main Methods:

  • A 10-year retrospective cohort study included 67 pediatric patients diagnosed with VTE.
  • Analysis focused on the relationship between thrombophilia status and anticoagulation duration, VTE recurrence rates, and imaging-confirmed thrombus resolution.

Main Results:

  • A positive thrombophilia workup did not significantly alter anticoagulation duration compared to negative results.
  • Thrombophilia status was not a significant predictor of VTE recurrence.
  • Positive thrombophilia workup was associated with a higher rate of Residual Vein Obstruction (RVO), but RVO did not predict recurrence.

Conclusions:

  • Thrombophilia testing in pediatric VTE patients did not impact treatment duration or recurrence prediction.
  • Findings support current guidelines favoring selective, clinically guided thrombophilia testing over routine use after an initial pediatric VTE event.
Abstract

Keywords:
AnticoagulationResidual vein obstructionThrombophiliaVenous thromboembolism

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