title: Paediatric thrombo-embolism: the influence of non-genetic factors and the role of activated protein C resistance and protein C deficiency.
abstract: In many children, the pathogenesis of thrombo-embolism remains unexplained. This study examines the role of non-genetic risk factors in 37 children with venous or arterial thrombosis. Included were 17 patients with portal vein thrombosis following umbilical vein catheterisation, 6 with portal vein thrombosis and an uneventful neonatal period, 4 with deep vein thrombosis, 4 with renal vein thrombosis after kidney transplantation, 1 haemodialysis patient with thromboses of arteriovenous shunts, and 5 with arterial thromboses at various sites. In 25 of these 37 patients (68%) exogenic risk factors and particularly vascular manipulations (24/37) were related to the thrombotic event. Resistance to activated protein C was identified in 5 patients and protein C deficiency in 2 (7/37; 19%). This prevalence was significantly higher than that of the control group (14/243; 5.8%; chi 2, P < 0.008).
  
  
  CONCLUSIONS
  Our data show that non-genetic and particular iatrogenic risk factors can often be identified in children with thrombosis, but activated protein C resistance and protein C deficiency are significant genetic risk factors in this age group.
authors.affiliation: Charité-Virchow Medical center, Department of General Paediatrics, Berlin, Germany.
authors.forename: M M
authors.initials: MM
authors.lastname: Uttenreuther-Fischer
authors.forename: B
authors.initials: B
authors.lastname: Vetter
authors.forename: C
authors.initials: C
authors.lastname: Hellmann
authors.forename: U
authors.initials: U
authors.lastname: Otting
authors.forename: S
authors.initials: S
authors.lastname: Ziemer
authors.forename: G
authors.initials: G
authors.lastname: Hausdorf
authors.forename: G
authors.initials: G
authors.lastname: Gaedicke
authors.forename: A E
authors.initials: AE
authors.lastname: Kulozik
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005165:Factor V / Q000235:genetics; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D011486:Protein C / Q000235:genetics / Q000378:metabolism*; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology* / Q000235:genetics; D013924:Thrombophlebitis / Q000453:epidemiology* / Q000235:genetics
chemical_list: D011486:Protein C; D005165:Factor V