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Overtight nappy precipitating thrombosis in antithrombin III deficiency
R Soutar1, V Marzinotto, M Andrew
1Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada.
Archives of Disease in Childhood
|November 1, 1993
Summary
An infant with antithrombin III deficiency developed iliac vein thrombosis, possibly due to a tight nappy. This case highlights the importance of assessing natural anticoagulants in children with venous thrombosis.
Area of Science:
- Pediatric Thrombosis
- Hematology
- Vascular Medicine
Background:
- Venous thromboembolism (VTE) is rare in children.
- Antithrombin III deficiency is a rare inherited thrombophilia.
- Infants are particularly susceptible to thrombosis due to physiological factors.
Observation:
- An infant with known antithrombin III deficiency presented with acute iliac vein thrombosis.
- The thrombosis appeared to be precipitated by external pressure from an overtight nappy.
- This clinical presentation is unusual for both healthy children and those with antithrombin III deficiency.
Findings:
- The case demonstrates a potential link between external pressure and VTE in a neonate with a thrombophilia.
- Antithrombin III deficiency significantly increases the risk of thrombosis, even with seemingly minor triggers.
- Diagnostic evaluation for inherited thrombophilias is crucial in pediatric VTE cases.
Implications:
- Clinicians should consider screening for inherited thrombophilias in infants and children presenting with venous thrombosis.
- Identifying and avoiding potential risk factors, such as excessive external pressure, is vital in managing pediatric VTE.
- Early diagnosis and management of antithrombin III deficiency can prevent recurrent thrombotic events and long-term complications.