Outcome of noncatheter-related thrombosis in children: influence of underlying or coexisting factors.
OBJECTIVE
To determine the hereditary and nonhereditary risk factors contributing to the development of noncatheter-related thrombosis in children.


METHODS
Ninety-five children with noncatheter-related thrombosis from a single center were analyzed for clinical manifestations and outcome during a period of 3.5 years. Patients with thrombosis were evaluated for congenital and acquired risk factors, and patients were screened for factor V Leiden, prothrombin 20210A mutations, protein C, protein S, antithrombin III deficiencies, and antiphospholipid antibodies.


RESULTS
Twelve patients (12.5%) died of thrombosis that was associated with a nonmalignant underlying disorder, and 19 patients (20%) had significant complications, including amputation of extremities, epilepsy, hemiplegia, portal hypertension, recurrence of deep vein thrombosis, and postphlebitic syndrome. Two common mutations (factor V Leiden and prothrombin 20210A) were found in 32.5% of the patients with thrombosis. The most frequent underlying disorder was infection (68%). Ninety-three patients (98%) had one or more risk factors.


CONCLUSIONS
The coexistence of an underlying disorder and the presence of predisposing factors such as infection and the factor V Leiden mutation may cause high rates of death and complications in children with noncatheter-related thrombosis. The results of this study indicate that the underlying disorder and the site of thrombosis determine the rates of death and complications in children with thrombosis.
Gurgey
A
A
Department of Pediatric Hematology, Hacettepe University, Ankara, Turkey. agurgey@genetic.gen.hun.edu.tr
Aslan
D
D
D000293:Adolescent; D017152:Antibodies, Antiphospholipid / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005165:Factor V / Q000032:analysis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011486:Protein C / Q000032:analysis; D017293:Protein S / Q000032:analysis; D013927:Thrombosis / Q000097:blood / Q000150:complications* / Q000209:etiology
D017152:Antibodies, Antiphospholipid; D011486:Protein C; D017293:Protein S; C095381:factor V Leiden; D005165:Factor V