Clin Pediatr Hematol Oncol.  2017 Apr;24(1):1-10. 10.15264/cpho.2017.24.1.1.

Venous Thromboembolism in Children

• Choi HS

• KMID: 2379345
• DOI: http://doi.org/10.15264/cpho.2017.24.1.1

Abstract

Although the incidence of venous thromboembolism (VTE) is significantly lower than in adults, recognition of VTE in children is increasing as advanced medical care enhances treatment intensity in pediatric patients. VTE in children usually develops as a secondary complication of underlying clinical conditions such as venous catheterization, malignancy, infections, trauma, surgery, and inherited or acquired thrombophilia, of which venous catheterization poses the highest risk. Neonates are at the greatest risk for VTE with a second peak in incidence during adolescence. There is some debate regarding which patients should have testing for inherited risk factors such as factor V Leiden, prothrombin G20210A, protein C-, protein S- and antithrombin deficiency. Guidelines for diagnosis and treatment of VTE in children are mostly extrapolated from adult data, despite the uniqueness of pediatric hemostatic system. The most common treatment is unfractionated heparin or low molecular weight heparin with vitamin K antagonist, whereas newly developed direct oral anticoagulants are under discussion and have been evaluated in only a small number of clinical trials in pediatric patients. Prospective multicenter collaborative research is necessary to develop validated guidelines for the diagnosis, antithrombotic therapy, prevention and follow-up monitoring of pediatric VTE.

Keyword

Venous thromboembolism; Children

MeSH Terms

Adolescent
Adult
Anticoagulants
Catheterization
Catheters
Child*
Diagnosis
Factor V
Follow-Up Studies
Heparin
Heparin, Low-Molecular-Weight
Humans
Incidence
Infant, Newborn
Prospective Studies
Prothrombin
Risk Factors
Thrombophilia
Venous Thromboembolism*
Vitamin K
Anticoagulants
Factor V
Heparin
Heparin, Low-Molecular-Weight
Prothrombin
Vitamin K