Abstract
Thrombosis is the result of an imbalance between two complex systems: hemostasis and fibrinolysis. Although the incidence of thromboembolism is lower in children than in adults, the associated morbidity is clinically relevant. This paper summarizes the main risk factors – important in defining effective strategies for primary thrombo-prophylaxis in children at risk, the diagnostic criteria and the optimal therapeutic approach, which have mostly been extrapolated from the adult’s recommendations until now.
Highlights
Thromboembolic disease is generally considered an adult pathology; its incidence has been increasing among pediatric population for the past two decades (1,2,3)
Thrombosis in children are correlated with significant morbidity and mortality rates, including the recurrence of venous thromboembolism, the post-thrombotic syndrome, as well as death caused by massive pulmonary thromboembolism (4)
Venous thromboembolism (VTE) is rare in children compared to adult, but it is increasingly recognized as a complication of intensive care therapeutic measures for previously lethal childhood diseases (5)
Summary
Thromboembolic disease is generally considered an adult pathology; its incidence has been increasing among pediatric population for the past two decades (1,2,3). A study from USA reported a 70 percent increase of VTE incidence between 2001 and 2007, from 34 cases per 10,000 children to 58 cases per 10,000 children in tertiary care hospitals (2). A recent study mentions a general mortality of 11.4 per 1,000 children/ year (10), only 1.5-2.2% being directly correlated to VTE (7). Death risk decreases with increasing age, due to the fact that VTE in young children often appears during critical diseases (5). Recent studies show an incidence of 3.4-11.4% of arterial thrombosis after cardiac catheterization, young age and low weight being associated with an increased risk (11,12)
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