Thrombophilia and varicella zoster in children

Ferrara, M.; Bertocco, F.; Ferrara, Dolores; Capozzi, L.

doi:10.1179/1607845412y.0000000055

Cited by 17 publications

(14 citation statements)

References 21 publications

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“…This could be due to the source of these infections which were mostly restricted to the nose and ear (in patients with mucormycosis and acute otitis media). The other reason might be the effect of infection in the induction of hypercoagulable state[1920] which may explain CVST in the patient with hepatitis B and the patient with a history of bacterial meningitis 1 month before thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran

Yadegari

Ghorbani

Miri

et al. 2016

Journal of Neurosciences in Rural Practice

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Introduction:Despite increasing the use of magnetic resonance imaging (MRI), cerebral venous sinus thrombosis (CVST) has remained an under-diagnosed condition. In this study, characteristics and frequency of various risk factors of CVST patients in a tertiary referral hospital were closely assessed.Methods:Patients with an unequivocal diagnosis of CVST confirmed by MRI and magnetic resonance venography during 6 years of the study were included. All data from the onset of symptoms regarding clinical signs and symptoms, hospital admission, seasonal distribution, medical and drug history, thrombophilic profile, D-dimer, neuroimaging, cerebrospinal fluid findings, mortality, and outcome were collected and closely analyzed.Result:A total of 53 patients with female to male ratio of 3.07 and mean age of 33.7 years were included in the study. Headache and papilledema were the most frequent clinical features (44 and 36 patients, respectively). An underlying disease (diagnosed previously or after admission) was the most common identified risk factor for CVST in both females and males (21 patients). A total of 15 women used the oral contraceptive pill (OCP) where 12 of them had simultaneously other predisposing factors. Overall, 19 patients (36%) had more than one contributing factor. D-dimer had a sensitivity of 71.4% in CVST patients. The mortality of patients in this study was 3.7% (n = 2). Focal neurologic deficit and multicranial nerve palsy were associated with poor outcome which defined as death, recurrence, and massive intracranial hemorrhage due to anticoagulation (P = 0.050 and 0.004, respectively).Conclusion:Unlike most of the CVST studies in which OCP was the main factor; in this study, an underlying disease was the most identified cause. Considering the high probability of multiple risk factors in CVST that was shown by this study, appropriate work up should be noted to uncover them.

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Section: Discussionmentioning

confidence: 99%

Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran

Yadegari

Ghorbani

Miri

et al. 2016

Journal of Neurosciences in Rural Practice

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“…In our series, as in the literature, the autoantibodies appear to fully disappear within a few weeks, irrespective of the treatment used. Two studies have reported an asymptomatic decrease in the level of protein S in the context of infection by VZV, but without association to antibodies or thrombotic symptoms 27,28 . The prevalence of anti-protein S antibodies is not known, nor are the factors that can favor progression to this acute and severe form of thrombophilia, as chickenpox and HHV6 infections are extremely common and IPF the exception.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic purpura fulminans associated with anti-protein S antibodies in children: a multicenter case series and systematic review

Théron¹,

Dautremay

Boissier

et al. 2022

Blood Advances

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Idiopathic purpura fulminans (IPF) is a rare but severe pro-thrombotic coagulation disorder that can occur after chickenpox or HHV6 infection. IPF leads to an autoantibody-mediated decrease in the protein S plasma concentration. We conducted a retrospective multicenter study involving IPF patients from 13 French pediatric centers and a systematic review of literature-published cases. Eighteen patients were included in our case series, and thirty-four as literature review cases. The median age was 4.9 years and the diagnostic delay after the first signs of viral infection was 7 days. The lower limbs were involved in 49 (94%) patients with typical lesions. A recent history of VZV or HHV6 infection was present in 41 (78%) and 7 (14%) of cases, respectively. Most of the patients received heparin (n=51, 98%) and fresh frozen plasma transfusions (n=41, 79%); other treatment options were immunoglobulin infusion, platelet transfusion, corticosteroid therapy, plasmapheresis, and coagulation regulator concentrate infusion. The antithrombin level and platelet count at diagnosis appeared to be associated with severe complications. Given the rarity of this disease, the creation of a prospective international registry is required to consolidate these findings.

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“…In our patient protein S levels were low and anti phospholipids antibodies were positive. Ferrara M et al, (2013) reported five VZV cases with deep venous thrombosis (DVT) and concluded that acute VZV infection could be associated with coagulation disorders and production of inhibitory protein S antibodies [2]. Recently Januario G et al, reported a case of post varicella purpura fulminans with low protein S levels in a child [3].…”

Section: Case Presentationmentioning

confidence: 99%

Cerebral venous sinus thrombosis (CVST) secondary to varicella induced hypercoagulable state in a adult

Barla¹,

Dnyaneshwar²,

Jaidip³

et al. 2014

Intern Med Inside

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Chicken pox (Varicella) infection is generally present in children and caused by Varicella Zoster Virus (VZV). There are quite a number of case reports of hypercoagulable state leading to deep venous thrombosis (DVT) and other thromboembolic sequelae following varicella induced auto antibodies to natural anticoagulants in children. But such a clinical entity is rarely seen in adults. Here we report a rare case of CVST in an adult due to low protein S levels following varicella zoster infection.

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Thrombophilia and varicella zoster in children

Cited by 17 publications

References 21 publications

Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran

Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran

Idiopathic purpura fulminans associated with anti-protein S antibodies in children: a multicenter case series and systematic review

Cerebral venous sinus thrombosis (CVST) secondary to varicella induced hypercoagulable state in a adult

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