INCIDENCE OF AND RISK FACTORS FOR CHILDHOOD THROMBOSIS: A Single-Center Experience in Ankara, Turkey

Abstract

This study was conducted to analyze the incidence of and risk for thrombosis in thrombotic children monitored in the Department of Pediatric Hematology of our hospital at the time of diagnosis, in addition to the clinical characteristics of those patients. The clinical and laboratory findings of 122 patients diagnosed with thrombosis from 1997 to 2006 were retrospectively analyzed. The incidence of thrombosis was 88.6/10,000 hospital admissions. The authors found that 31.1% of the patients studied had a thrombosis in more than 1 region. The incidence of thrombosis by anatomic site was as follows: 42 thromboses in the peripheral arterial system, 39 in an intracardiac region, 38 in the abdominal venous system, 36 in the deep peripheral venous system, and 28 in the cerebral vascular system. The mean age of the patients at the time of diagnosis was 4.9 years. Of the patients studied, 10.7% were neonates, 35.3% were infants younger than 1 year, and 48.4% were younger than 2 years. Most of the patients had a congenital cardiac disease and spontaneous thrombosis, and 66.1% had at least 1 acquired risk factor, the most common of which were having undergone surgery (42%) or wearing a central venous catheter (39%). A hereditary factor for the development of thrombosis was present in 54% of the patients. The most frequently observed hereditary risk factor was the MTHFR 677C-T mutation, and the second most common was the factor V Leiden mutation. Thrombosis should be considered a systemic disorder, and thrombotic patients should be evaluated with appropriate methods. Acquired and hereditary risk factors should be analyzed systematically in thrombotic patients.

Thromboembolism and venous thrombosis of the deep veins in surgical children—an increasing challenge?

“…It may be classified by anatomical site, and surgical risk factors include indwelling venous catheters, reduced lack of mobility after surgery, and a variety of intrinsic hematologic prothrombotic factors such as factor V Leiden, antiphospholipid antibodies, or prothrombin G20210A mutations. The risk of venous thromboembolism in children is not known, although a number of recent reports have suggested it is not as low as it has been perceived [5,7,12] and that its prevalence in hospitalized children may well approach that of the adult population [13]. One North American study calculated an overall prevalence of 0.07/10,000 children, which increased to 3.5 per 10,000 at hospitalization and was 4.2 per 1000 at the time of discharge [7].…”

Trombozla başvuran pediatrik hastaların risk faktörleri açısından retrospektif olarak değerlendirilmesi: tek merkez deneyimi

“…In the study sample of Ozbek et al, the most common localization was reported to be the intracardiac thrombus, which was explained by the fact that their host institution was a reference hospital for cardiovascular surgery 7 . Pulmonary thromboembolism is usually associated with deep vein thrombosis.…”

“…In their study, Ozbek et al reported congenital heart disease as the most common predisposing factor in children with thrombosis, which was followed by infectious diseases. They explained this finding by the fact that the study environment was an important cardiovascular surgical center 7 . Although trauma is known to be one of the most important factors predisposing to thrombosis in adults, it is less common in children 25,26 .…”

“…Tavil et al detected MTHFR 677CT mutation in 1 of the 16 patients diagnosed with pulmonary embolism (6.25%), FV Leiden mutation in 2 patients (12.5%) 15 . In a study by Ozbek et al, the MTHFR 677CT mutation was the most common with an incidence of 40.7%, respectively followed by FV Leiden mutation (14.1%) and prothrombin 20210GA mutation (4.4%) 7 . Broadly consistent with earlier research, the most common mutation in our study was MTHFR 677CT (60%), and the second most common was MTHFR 1298C (54%), followed by FV Leiden mutation (15%) ( Table-3).…”

Catastrophic Arterial Thrombosis in an Infant Undergoing Neuroblastoma Resection

“…A dopamine infusion was started for refractory hypotension. Surgical exploration revealed the small bowel to be diffusely dusky and ischemic; the surgeon identified a thrombus in the superior mesenteric artery (SMA) (Figure 2 & 3) [1][2][3]. An ABG returned with a pH 7.047 in the setting of profound lactate acidosis with a lactate of 10.4 mmol/L.…”