title: Evaluation and treatment of neonatal thrombus formation in 17 patients.
abstract: BACKGROUND
  Thrombosis is a rare but serious event in neonates. Perinatal risk factors associated with the developing hemostatic system increase the risk of thromboembolism. Treatment protocols vary between different centers. In this study, thrombosis and subsequent treatment were evaluated in 17 neonates hospitalized in a neonatal intensive care unit. This is the largest series reported to date.
  
  
  METHODS
  From January 2007 to December 2009, thrombosis was diagnosed in 17 newborns hospitalized in a neonatal intensive care unit. Most were treated with recombinant tissue plasminogen activator (r-tPA) and enoxaparin as anticoagulant therapy.
  
  
  RESULTS
  Eleven courses of r-tPA therapy were administered to 10 patients. Sixteen patients received low-molecular-weight heparin (LMWH) treatment. None of the patients had hemorrhagic complications due to therapy. Recurrence was observed in 1 patient 1.5 months after the first course of r-tPA and retreatment was performed. A complete decrease in thrombus size was achieved in 9 patients and a partial decrease in 5 patients. One patient died before treatment was initiated; another died at the end of the first day of treatment and thus could not be evaluated. One patient who had a homozygous mutation for factor V Leiden did not respond to treatment and the extremity involved was amputated.
  
  
  CONCLUSIONS
  Thrombosis in neonates is a multifactorial disorder. Treatment consisting of r-tPA and an anticoagulant was shown to be a safe and effective approach to clot dissolution in neonates.
authors.affiliation: Neonatology Division, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey. kgamze@hotmail.com
authors.forename: Gamze
authors.initials: G
authors.lastname: Demirel
authors.forename: Serife Suna
authors.initials: SS
authors.lastname: Oguz
authors.forename: Istemi Han
authors.initials: IH
authors.lastname: Celik
authors.forename: Nahide
authors.initials: N
authors.lastname: Altug
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator