title: The clinical outcome after inferior vena cava thrombosis in early infancy.
abstract: The clinical outcome after inferior vena cava thrombosis in early infancy is unknown. We report the clinical long-term follow-up of 12 patients presenting inferior vena cava thrombosis within their first months of life (gestational age: 24-41 weeks; follow-up: 7+/-3 years). Accompanying renal venous thrombosis occurred in 9, and adrenal bleeding in 4 patients. A central venous catheter was related to the thrombosis in only four patients. Heterozygous factor V Leiden mutation was found in two of the eight infants without central venous catheter. Thrombolysis was performed in seven and effective in three infants; one infant required surgical thrombectomy. In three of eight infants with ineffective or with no therapy, spontaneous recanalization occurred during follow-up. No patient died of the thrombosis. Although no long-term anticoagulatory prophylaxis was performed, none of the children with persisting occlusion (n = 5) or stenosis (n = 1) of the inferior vena cava developed symptomatic thrombo-embolic complications. However, extensive internal collaterals (n = 6), visible varicosis (n = 5), pain in the legs (n = 3) and persisting renal disease (n = 3) with arterial hypertension (n = 2) were observed during follow-up.
  
  
  CONCLUSIONS
  Inferior vena cava thrombosis of early infancy frequently persists and may cause considerable long-term morbidity. New strategies for early and long-term therapy are necessary.
authors.affiliation: Department of Paediatrics, University Hospital RWTH Aachen, Germany. Haeusler@RWTH-Aachen.de
authors.forename: M
authors.initials: M
authors.lastname: Häusler
authors.forename: D
authors.initials: D
authors.lastname: Duque
authors.forename: U
authors.initials: U
authors.lastname: Merz
authors.forename: R
authors.initials: R
authors.lastname: Mertens
authors.forename: E
authors.initials: E
authors.lastname: Mühler
authors.forename: H
authors.initials: H
authors.lastname: Hörnchen
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014682:Vena Cava, Inferior