Prothrombotic factors in children with otitis media and sinus thrombosis.
OBJECTIVE
Venous sinus thrombosis (VST) is the second most common intracranial complication of acute otitis media (AOM). There is some evidence that hereditary and acquired prothrombotic disorders are risk factors for VST. The aim of the present study was to evaluate whether children with AOM complicated VST have a prothrombotic tendency, which might have important therapeutic and preventive implications.


METHODS
Retrospective.


METHODS
The files of children hospitalized at Schneider Children's Medical Center of Israel, a tertiary referral center, from 1999 to 2002, because of AOM complicated by acute mastoiditis and VST were reviewed. All children underwent laboratory work-up for hypercoagulability.


RESULTS
Seven children met the study criteria. Of these, five had prothrombotic disorders, namely elevated levels of lipoprotein apolipoprotein (Lp[a]) (n = 4), antibodies to beta 2-glycoprotein and to cardiolipin (markers of antiphospholipid syndrome) (n = 4), and heterozygosity for factor V Leiden mutation (n = 1). One child had three abnormalities, two children had two abnormalities, and two children had one abnormality.


CONCLUSIONS
A prothrombotic tendency may exist in children with AOM complicated by mastoiditis and VST. Further studies are needed to evaluate its extent.
Oestreicher-Kedem
Yael
Y
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Israel. dkyo@barak-online.net.il
Raveh
Eyal
E
Kornreich
Liora
L
Yaniv
Isaac
I
Tamary
Hannah
H
D000208:Acute Disease; D000925:Anticoagulants / Q000276:immunology; D002308:Cardiolipins / Q000276:immunology; D002675:Child, Preschool; D005165:Factor V / Q000235:genetics; D005260:Female; D006023:Glycoproteins / Q000276:immunology; D006579:Heterozygote; D006801:Humans; D017270:Lipoprotein(a) / Q000378:metabolism; D008297:Male; D008417:Mastoiditis / Q000097:blood / Q000209:etiology; D010033:Otitis Media / Q000097:blood* / Q000150:complications; D017354:Point Mutation; D012189:Retrospective Studies; D012307:Risk Factors; D012851:Sinus Thrombosis, Intracranial / Q000097:blood* / Q000209:etiology; D019851:Thrombophilia / Q000175:diagnosis*; D053482:beta 2-Glycoprotein I
D000925:Anticoagulants; D002308:Cardiolipins; D006023:Glycoproteins; D017270:Lipoprotein(a); D053482:beta 2-Glycoprotein I; C095381:factor V Leiden; D005165:Factor V