Age-Related Reference Values for Activation Markers of the Coagulation and Fibrinolytic Systems in Children

Changes in hypercoagulability by asparaginase: a randomized study between two asparaginases

“…We constructed our own pediatric reference values on 62 healthy children between 1 and 15 years old; reference values for TAT plasma levels were median 2.7 mg/l (fifth to 95th percentile 1.1-4.3 mg/l). These reference values were in line with the values as determined by Ries et al [16].…”

“…The values of activation markers like F1þ2, TAT, PAP and D-dimer are similar in children and adults, as was demonstrated by Ries et al [16]. So we were able to adapt the reference values for adults as provided by the manufacturers.…”

Maternal thrombophilia and neonatal thrombosis

“…20 Antithrombin, heparin cofactor II and protein C are reduced to approximately 50% of that of adults, whereas alpha-2 macroglobulin is increased over adult values at birth, reaching twice adult values by 6 months of age. 19,21 Furthermore, the decreased capacity of newborn plasma to generate thrombin is dependent mainly on plasma concentrations of prothrombin, a fact that is therefore discussed as a source of further protection from thrombotic events during infancy and childhood. Whereas the characteristics of some components of the procoagulant coagulation system may contribute to a reduced risk of thromboembolism during infancy, there is no evidence that fibrinolytic proteins provide protection from vascular accidents in the very young.…”

Bleeding and Thrombosis Issues in Pediatric Patients: Current Approach to Diagnosis and Treatment

“…Due to the special properties of the pediatric hemostatic system, thrombotic manifestation occurs in 0.07/10,000 children, 5.3/10,000 pediatric hospital admissions, and 2.4/1,000 admissions of newborns to intensive care units. Neonates are at the highest risk of thromboembolic complications as compared to older children, with a reported annual incidence of 0.5/10,000 live births in Caucasian children, possibly due to the lower concentrations of the physiological inhibitors of the coagulation system along with their markedly reduced fi brinolytic capacity [17,18] . The incidence of vascular accidents decreases signifi cantly after the fi rst year of life, with a second peak during puberty and adolescence again associated with reduced fi brinolytic activity [17] .…”

“…Thrombolytic agents may be used during acute thrombotic events, and are currently mainly applied in neonates [30] , due to the physiologically reduced fi brinolytic capacity of this age group [18] . In pediatric patients with thrombosis, however, antithrombotic treatment protocols cannot automatically be adjusted from adults.…”