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Disorders of hemostasis in childhood: risk factors for venous thromboembolism
1Department of Pediatrics, University of Colorado, Health Sciences Center, Denver, USA.
Insights
Identifying risk factors for pediatric venous thrombosis is crucial. Underlying conditions, trigger events like catheters or surgery, and coagulation abnormalities necessitate thorough evaluation in children and neonates.
Area of Science:
- Pediatric Hematology
- Thrombosis Research
- Coagulation Disorders
Background:
- Venous thrombosis in children and neonates often involves identifiable risk factors.
- Prothrombotic medical conditions and trigger events (catheter, surgery, trauma) are common.
- Genetic and acquired coagulation abnormalities are also significant in pediatric venous thrombosis.
Purpose of the Study:
- To highlight the importance of identifying predisposing factors in pediatric venous thrombosis.
- To emphasize the role of underlying conditions and trigger events.
- To advocate for comprehensive coagulation testing in affected children.
Main Methods:
- Review of risk factors associated with venous thrombosis in pediatric populations.
- Identification of common underlying prothrombotic conditions.
- Recognition of trigger factors such as medical devices and surgical procedures.
- Assessment of genetic and acquired coagulation abnormalities.
Main Results:
- Multiple predisposing risk factors are generally identified in neonates and children with venous thrombosis.
- Underlying prothrombotic conditions and trigger factors are frequently observed.
- Genetic and acquired coagulation abnormalities are found in a significant proportion of appropriately studied children.
Conclusions:
- A thorough evaluation for venous thrombosis in children and neonates should include a detailed family history.
- Testing for lupus anticoagulant (LA), antithrombin-III (AT-III), protein C, protein S, and the factor V Leiden mutation is recommended.
- Comprehensive assessment aids in understanding and managing pediatric venous thrombosis.
Abstract:
In both children and neonates with venous thrombosis, one or more predisposing risk factors can generally be identified. Underlying prothrombotic medical conditions are common in these patients. In addition, a "trigger factor" such as a catheter, surgery or trauma is usually present. However genetic and acquired coagulation abnormalities are also identified in children with venous thrombosis who are appropriately studied. A careful family history and assays for the LA, AT-III, protein C, protein S and the factor V Leiden mutation should be part of the evaluation of infants and children with venous thrombosis.