Acquired and Heritable Thrombophilia in Indian Patients With Pediatric Deep Venous Thrombosis (DVT)

Pai, Navin; Ghosh, Kanjaksha; Shetty, Shrimati

doi:10.1177/1076029613476339

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…Infection is often cited as a risk factor without descriptors of location, extent, severity, or inciting organism (29, 30). Occasionally, a specified set of infectious conditions (e.g., meningitis, bacteremia) are categorized as “infection” (31), or infection is dichotomized to focal or systemic.…”

Section: Risk Factorsmentioning

confidence: 99%

Epidemiology and Risk Assessment of Pediatric Venous Thromboembolism

Mahajerin

Croteau

2017

Front. Pediatr.

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The incidence of diagnosed venous thromboembolism (VTE) has been increasing concurrent with advances in technology and medical care that enhance our ability to treat pediatric patients with critical illness or complex multiorgan system dysfunction. Although the overall incidence of VTE is estimated at 0.07–0.49 per 10,000 children, higher rates are observed in specific populations including hospitalized children, those with central venous catheters (CVCs) or patients convalescing from a major surgery. While the absolute number of pediatric VTE events may seem trivial compared to adults, the increasing incidence, associated with increased mortality and morbidity, the availability of novel therapies, and the impact on the cost of care have made investigation of VTE risk factors and prevention strategies a high priority. Many putative risk factors for pediatric VTE have been reported, primarily from single-institution, retrospective studies which lack appropriate methods for verifying independent risk factors. In addition, some risk factors have inconsistent definitions, which vex meta-analyses. CVCs are the most prevalent risk factors but have not consistently been assigned the highest level of risk as defined by odds ratios from retrospective, case–control studies. Few risk-assessment models for hospital-acquired pediatric VTE have been published. Some models focus exclusively on hospitalized pediatric patients, while others target specific populations such as patients with cancer or severe trauma. Multicenter, prospective studies are needed to identify and confirm risk factors in order to create a pediatric risk-assessment tool and optimize preventive measures and reduce unintended harm.

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Section: Risk Factorsmentioning

confidence: 99%

Epidemiology and Risk Assessment of Pediatric Venous Thromboembolism

Mahajerin

Croteau

2017

Front. Pediatr.

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“…Acquired Protein C and S deficiencies with consumption of protein C occurred in patients with deep venous thrombosis, pulmonary embolism, acute disseminated intravascular coagulopathy, post-operative state, severe liver disease, malignancy, infection, hemolytic-uremic syndrome, adult respiratory distress syndrome and vitamin K, primary myloproliferative disease, antiphospholipid antibody, paroxysmal nocturnal hemoglinopathy, contraceptive, childbirth, and hypercystinemia. [6][7][8][9] Modestly elevated levels of plasma homocysteine, which are in part genetically determined, have also recently been associated with an increased risk for venous thromboembolism. Van Der Meer described that however heritable deficiencies of the endogenous anticoagulants protein C, protein S, and antithrombin have been recognized for decades but they are uncommon, even in patients with familial thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Right atrial thrombosis associated with sagittal sinus thrombosis caused by protein C-S deficiency

Sabzi

Faraji

2013

J Nepal Med Assoc

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Right atrial thrombi may develop within the right atrium or may have peripheral venous origins that, on their way to the final destination site lodge in, right atrium. Right atrial thrombosis is classified as two type: A (mobile, thin) and B (non mobile and attached to atrial wall) that they are probably of cardiac origin due to local pathology, indwelling catheter, atrial fibrillation, stasis, rheumatological or hematological disease like protein C or S deficiency. Protein C deficiency has been reported to be a risk factor for thrombosis in multiple organs as a result of inactivation of factor of Va. We describe a case of a huge right atrial thrombus with cerebral sagittal sinus thrombosis, in a protein C-S deficient patient, in which right atrial clot was successfully removed surgically and sagittal vein treated conservatively with full recovery of his central neurologic symptom.

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“…9 Of the inherited thrombophilias, factor V Leiden mutation, which is the major causative factor in BCS and portal vein thrombosis cases in the adult group, is not a major contributing factor in pediatric group, that is, 1.8% of the patients. 10 Inferior vena cava thrombosis can be superimposed on a previous stenosis/web or can occur spontaneously. Hepatic veins are usually involved progressively but in an asynchronous manner.…”

Section: Pathophysiologymentioning

confidence: 99%

Ultrasound and Doppler Features of Budd-Chiari Syndrome in Pediatric Population

Trivedi¹,

Thakkar²,

Sannananja³

et al. 2015

Ultrasound Quarterly

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Budd-Chiari syndrome (BCS) occurs as a result of hepatic venous outflow obstruction. In the pediatric population, the etiologies vary as compared with the adult population. Decompensation can occur faster in this set of patients. Ultrasound and Doppler represent important imaging modalities for diagnosing BCS in children. The imaging features differ depending upon the level of obstruction, acuteness of the condition, and secondary decompensation. Caudate lobe hypertrophy is a salient feature. Obstruction at the level of hepatic veins may be manifested by ostial narrowing, echogenic thrombus, and altered flow patterns in the form of turbulent flow, nonvisualization of the veins, or reversal of flow. Obstruction in the inferior vena cava may present as an echogenic web, membrane, or thrombus with turbulent flow to absent flow within depending upon the degree of luminal compromise. Collateral formation is an important distinctive feature of subacute and chronic BCS. Collaterals that develop may be of intrahepatic or extrahepatic type. Secondary signs of liver failure would be present in late stages. Understanding the clinical presentation and imaging features can help in achieving the correct diagnosis because an early diagnosis of the disease will impact patient management.

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Acquired and Heritable Thrombophilia in Indian Patients With Pediatric Deep Venous Thrombosis (DVT)

Cited by 5 publications

References 27 publications

Epidemiology and Risk Assessment of Pediatric Venous Thromboembolism

Epidemiology and Risk Assessment of Pediatric Venous Thromboembolism

Right atrial thrombosis associated with sagittal sinus thrombosis caused by protein C-S deficiency

Ultrasound and Doppler Features of Budd-Chiari Syndrome in Pediatric Population

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