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Thrombophilia testing in children: A 7 year experience
Author(s) -
Mahajerin A.,
Obasaju P.,
Eckert G.,
Vik T.A.,
Mehta R.,
Heiny M.
Publication year - 2014
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24846
Subject(s) - medicine , thrombophilia , methylenetetrahydrofolate reductase , factor v leiden , coagulopathy , activated protein c resistance , protein s , hyperhomocysteinemia , protein s deficiency , pediatrics , protein c , gastroenterology , thrombosis , venous thrombosis , risk factor , allele , biochemistry , chemistry , gene
Background Incidence of venous thromboembolism (VTE) in children is reported to be increasing. We examined thrombophilia testing results in children with VTE that presented in inpatient and outpatient settings to explore patterns of thrombophilia testing. Procedure Patients/Methods : Children, ages 0–20 years with VTE seen at our institution from Jan 2005 to Apr 2012 were studied retrospectively. All patients with VTE confirmed by imaging were eligible and the presence of significant risk factors was evaluated. Thrombophilia was diagnosed if > 1 tests confirmed: persistently low protein C (PC), protein S (PS), and antithrombin (AT) following VTE resolution, persistent antiphospholipid antibodies (APA) positivity >12 weeks from first test, factor V Leiden (FVL) and prothrombin mutation (PTm) hetero‐ or homozygosity, elevated plasminogen activator inhibitor (PAI‐1) levels with 4G/5G or 4G/4G polymorphisms, methylene tetrahydrofolate reductase (MTHFR) polymorphisms with elevated fasting homocysteine levels. Results Three hundred ninety‐two patients met inclusion criteria. At least one test was ordered in 157/239 inpatients. All 153 outpatients had > 1 test ordered. Thrombophilia rate differences between inpatients and outpatients did not reach statistical significance except for PC deficiency, which was significantly higher in outpatients. Of inpatients, central venous line (CVL) was significantly associated with not having tests done ( P < 0.0022). Conclusions This study of pediatric VTE demonstrated a low thrombophilia rate in both inpatient and outpatient populations. The role of testing in other pediatric patients should be further explored. Pediatr Blood Cancer 2014;61:523–527. © 2013 Wiley Periodicals, Inc.