title: Postthrombotic syndrome following upper extremity deep vein thrombosis in children.
abstract: Despite its relatively estimated high occurrence, the characterization of pediatric upper extremity deep vein thrombosis (UE-DVT) and of UE postthrombotic syndrome (PTS) is still lacking. We investigated the occurrence, characteristics, and predictors of UE-PTS in a cohort of children with objectively confirmed UE-DVT. Patients were analyzed in 3 groups according to DVT pathogenesis and neonatal status: primary (G1), secondary neonates (G2neonates), and non-neonates (G2non-neonates). A total of 158 children (23 G1, 25 G2neonates, and 110 G2non-neonates) were included. The most common triggering factors were effort-related (87%) in G1 and central lines in G2neonates (100%) and in G2non-neonates (92%). PTS scores ≥1, as per the Modified Villalta Scale, were identified in 87% of primary patients, 16% of G2neonates, and 49% of G2non-neonates. Survival analysis showed that the time to PTS score ≥1 significantly differed among group (log-rank test P < .0001). A multivariable logistic regression showed that DVT pathogenesis and imaging-determined degree of thrombus resolution at the end of therapy were independent predictors of a PTS score ≥2. In conclusion, pediatric UE-PTS frequency and severity depend on UE-DVT pathogenesis (primary/secondary) and, within the secondary group, on patient's age. Line-related UE-PTS has a more benign course, particularly in neonates.
authors: Division of Hematology/Oncology, Department of Pediatrics, and.
authors: Maria L
authors: ML
authors: Avila
authors: Division of Hematology/Oncology, Department of Pediatrics, and.
authors: Lucy
authors: L
authors: Duan
authors: Division of Hematology/Oncology, Department of Pediatrics, and.
authors: Amanda
authors: A
authors: Cipolla
authors: Division of Hematology/Oncology, Department of Pediatrics, and.
authors: Ashley
authors: A
authors: Kim
authors: Division of Hematology/Oncology, Department of Pediatrics, and Department of Biochemistry, University of Toronto, Program in Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada.
authors: Walter H A
authors: WH
authors: Kahr
authors: Division of Hematology/Oncology, Department of Pediatrics, and.
authors: Suzan
authors: S
authors: Williams
authors: Division of Hematology/Oncology, Department of Pediatrics, and.
authors: Leonardo R
authors: LR
authors: Brandão
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods*; D015999:Multivariate Analysis; D054070:Postthrombotic Syndrome / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011379:Prognosis; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D056824:Upper Extremity Deep Vein Thrombosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000925:Anticoagulants