Formation of a high thrombogenic risk groups in children with manifestation of hemorrhagic syndrome

Abstract

Introduction. Children suffering from congenital thrombophilia may suffer from manifestations of the increased bleeding in certain periods of childhood. With regard to the occurrence of acute cerebrovascular accident, infarctions, transient ischemic attacks, genetic polymorphisms of thrombophilia have been well studied, but they have not been fully analyzed in children with the aspects of hemorrhagic syndrome. The aim of the study: to assess the prognostic significance of permanent and temporary thrombogenic risk factors for the formation of a risk groups for the development of vascular complications in children with manifestations of hemorrhagic syndrome. Materials and methods. The study included ninety 0 to 18 years children with clinical manifestations of hemorrhagic syndrome. The control group consisted of 115 children without clinical manifestations of bleeding. Determination of genetic polymorphisms of hemostasis system factors and folate cycle enzymes was carried out by the molecular genetic method, using the polymerase chain reaction. Statistical processing of the results was carried out using the statistical software package Statistica 10.0 (StatSoft Inc.) was used to organize, sort, and analyze data. Results. Children with manifestation of hemorrhagic syndrome were established to have a statistically significant prevalence of carriage of the Hmzg genotype of the ITGA2 gene and the Hmzg gene PAI-1 (p < 0.05). The prognostic significance and informativeness of a number of constant and temporary signs were established, from which a prognostic table was compiled for the selection of children in the risk group for the development of vascular complications with the subsequent development of individual measures for primary thromboprophylaxis. Conclusion. Thus, the developed prognostic table characterizes the maximum value of specificity, the maximum value of sensitivity and the prognostic randomness of a positive result. When working with the proposed table, no more than 5% of erroneous decisions can be made. Using this indicator, children with a risk of developing vascular diseases were identified and included in the regional register, with subsequent additional examination and specific thromboprophylaxis.