title: Inherited thrombophilia in childhood arterial stroke: data from Lebanon.
abstract: Pediatric ischemic stroke still represents a burden, and more than half of the survivors will experience cognitive or motor disabilities. The objective of this study was to investigate the role of thrombophilia in a cohort of children with arterial ischemic stroke. The records of infants and children with clinically and radiologically confirmed stroke were reviewed. Patients with venous or perinatal stroke were not included. Thirty-three patients were diagnosed with arterial ischemic stroke. The male/female ratio was 1.75:1. The median age was 4 years. The most frequent clinical manifestations were hemiparesis (54.5%) and seizures (33.3%). Genetic thrombophilia testing was available on 24 patients. Nine of the 24 patients (37.5%) were heterozygous for factor V Leiden. None of the patients carried the factor II G20210A variant. Ten patients (41.7%) were heterozygous and 3 (12.5%) were homozygous for methylenetetrahydrofolate reductase (MTHFR) C677T variant. Fifteen patients (62.5%) had one or more genetic polymorphism. Factor V Leiden was significantly associated with arterial ischemic stroke (P < 0.001). Stroke recurred in 2 children with multiple risk factors and MTHFR C677T mutation. Factor V Leiden is one of the major genetic risk factors for pediatric arterial ischemic stroke in Lebanon. MTHFR C677T was prevalent among patients with recurrent stroke.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Hematology Oncology Service, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Samar A
authors.initials: SA
authors.lastname: Muwakkit
authors.forename: Marianne
authors.initials: M
authors.lastname: Majdalani
authors.forename: Roula
authors.initials: R
authors.lastname: Hourani
authors.forename: Rami A
authors.initials: RA
authors.lastname: Mahfouz
authors.forename: Zaher K
authors.initials: ZK
authors.lastname: Otrock
authors.forename: Christina
authors.initials: C
authors.lastname: Bilalian
authors.forename: Anthony K
authors.initials: AK
authors.lastname: Chan
authors.forename: Miguel
authors.initials: M
authors.lastname: Abboud
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Mikati
mesh_terms: D000293:Adolescent; D002545:Brain Ischemia / Q000150:complications / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005165:Factor V / Q000235:genetics; D005260:Female; D006801:Humans; D007223:Infant; D007861:Lebanon; D008279:Magnetic Resonance Imaging; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D010291:Paresis / Q000209:etiology; D011110:Polymorphism, Genetic / Q000235:genetics; D011516:Prothrombin / Q000235:genetics; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012640:Seizures / Q000209:etiology; D020521:Stroke / Q000150:complications* / Q000235:genetics*; D019851:Thrombophilia / Q000209:etiology* / Q000235:genetics*
chemical_list: D005165:Factor V; D011516:Prothrombin; D042965:Methylenetetrahydrofolate Reductase (NADPH2)