Abstract
Thromboembolic disorders are frequent complications in pediatric patients and the
incidence seems to rise. Adult guidelines for thromboembolism do not hold for children
because there are many age-related features.
Congenital prethrombotic disorders play a major role in the pediatric population and
activated protein C (APC) resistance is also the most frequently encountered problem.
Acquired risk factors in children are central venous line thrombosis with serious
complications, cardiac diseases such as cardiomyopathies, prosthetic heart valves
and aneurysms, renal vein thrombosis, and nephrotic syndrome. Renal vein thrombosis
primarily affects newborns. Children with the antiphospholipid antibody syndrome also
have thromboses although less frequent than adults, but systemic lupus erythematosus
is associated with a high incidence. Acute lymphoblastic leukemia is frequently associated
with thrombosis in children, especially when complicated by APC resistance.
The greatest risk of thrombosis in children is during the neonatal period, and again
congenital prethrombotic states and catheter placement play a major role.
The clinical manifestations in children reflect the site of the thrombosis and extensive
laboratory evaluations and advanced diagnostic procedures must be employed to diagnose
the thrombotic events.
Keywords:
Thromboembolic diseases - children - newborn - activated protein C resistance - central
venous lines - antiphospholipid antibody syndrome
