Incidences, risk factors and outcomes of neonatal thromboembolism

Sirachainan, Nongnuch; Limrungsikul, Anchalee; Chuansumrit, Ampaiwan; Nuntnarumit, Pracha; Thampratankul, Lunliya; Wangruangsathit, Somporn; Sasanakul, Werasak; Kadegasem, Praguywan

doi:10.1080/14767058.2017.1285892

Cited by 33 publications

(23 citation statements)

References 12 publications

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“…In this study, 63.3% (19/30) of the children presented with obvious cases of the disease, which is far lower than the 85% reported in international studies (10). These results suggest it is necessary to determine other causes, including anti-prothrombin deficiency and protein C or protein S deficiencies (11). The role of polycrystalline, coagulation, and fibrinolysis system gene polymorphisms in the pathogenesis of CVST is currently receiving increased attention.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

et al. 2019

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Background: Cerebral venous sinus thrombosis (CVST) in children is rare in a clinical setting. The aim of this study was to summarize the etiological, clinical, and imaging characteristics of CVST in children.Methods: We retrospectively analyzed the data of 30 patients with a diagnosis of CVST who were admitted to Children's Hospital of Fudan University from 2008 to 2018. The medical records, including clinical manifestations, laboratory data, neurological findings, treatment, and short-term prognosis were analyzed.Results: Etiologically, the causes of CVST were infection (7/30), tumor (3/30), nephritis or nephrotic syndrome (8/30), traumatic brain injury (1/30), and undefined disease (11/30). All 30 cases were diagnosed with CVST after a neuroimaging examination using brain magnetic resonance imaging (MRI) combined with magnetic angiography venography (MRV). With regard to short-term prognosis, all the patients were treated with anticoagulants, after which 26 cases improved.Conclusions: CVST patients do not typically present with specific clinical manifestations, which leads to a high rate of misdiagnosis and delayed therapy. Increased consideration and prompt MRV checkup plays a key role in achieving an accurate diagnosis. Overall, anticoagulation is a safe and effective treatment for CVST.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

et al. 2019

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“…PC deficiency is the most common thrombophilia as the cause of pediatric thrombosis in Japan [28]. These patients have one allele or double allele mutations of PROC , and develop hemorrhagic infarction and/or purpura fulminans within two weeks after birth [14, 18], although thrombotic trend depends on the absolute PC activity levels [15]. Because of the varied hemostatic maturation [29], it is difficult to assess the balanced development of coagulation, anticoagulation and fibrinolysis factors during the early postnatal life.…”

Section: Discussionmentioning

confidence: 99%

“…The allele frequency of FVL or FII variant shapes the landscape of molecular epidemiology for inherited thrombosis in Caucasians [9–11]. By contrast, the absence of FVL or FII variant in East Asia raises the clinical impact of PC, PS, and AT deficiency on thromboembolism in Asian patients [12–14]. Severe PC deficiency is a rare thrombophilia.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic challenge of the newborn patients with heritable protein C deficiency

et al. 2018

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AbstarctObjectiveThe diagnosis of neonatal-onset protein C (PC) deficiency is challenging. This study aimed to establish the neonatal screening of heritable PC deficiency in Japan.Study designWe determined the changes in plasma activity levels of PC and protein S (PS) in healthy neonates, and studied newborn patients with PROC mutation in the Japanese registry.ResultPhysiological PC and PS levels increased with wide range. The PC/PS-activity ratios converged after birth. The PC/PS-activity ratios of 19 patients with biallelic mutations, but not, 9 with monoallelic mutation, were lower than those of 13 without mutation. The logistic regression analyses established a formula including two significant variables of PC activity (cut-off < 10%, odds ratio = 30.0) and PC/PS-activity ratio (cut-off < 0.35, odds ratio = 22.7), with 93% sensitivity and 44% specificity for determining patients with mutation(s).ConclusionThe PC/PS-activity ratio is an effective parameter for the genetic screening of neonatal-onset PC-deficiency in Japanese population.

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“…The annual incidence of CVST in the pediatric population is approximately seven cases per million and is higher in neonates than in children . The sex ratio seems balanced because of the absence of sex‐specific risk factors .…”

Section: Epidemiologymentioning

confidence: 99%

Cerebral venous sinus thrombosis

Capecchi

Abbattista

Martinelli

2018

Journal of Thrombosis and Haemostasis

173

174

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The cerebral venous system is an unusual site of thrombosis, with a particularly high incidence in young adults. This incidence has increased in past decades because of the improvement of neuroradiological techniques. Risk factors for cerebral venous sinus thrombosis overlap with those of other venous thromboembolism sites; however, some are specific for this particular anatomical district. Prognosis is favorable in most cases if diagnosis is made rapidly and treatment is promptly initiated, even if acute complications or chronic invalidity still occur in a quarter of patients. The mainstay of treatment is anticoagulation, which is necessary in order to block clot propagation and obtain recanalization. Intracranial bleeding does not contraindicate anticoagulation. Endovascular procedures are reserved for patients with a particularly severe presentation or rapidly declining neurological symptoms despite appropriate anticoagulation, although data from clinical trials are lacking. Specifically, this review addresses the epidemiology, clinical presentation and course, risk factors, and treatment of cerebral venous sinus thrombosis, with a special focus on the pediatric population.

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Incidences, risk factors and outcomes of neonatal thromboembolism

Abstract: The most common TE was AIS. PC deficiency was the most prevalent inherited risk factor, especially in neonates without precipitating factors.

Cited by 33 publications

References 12 publications

Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

Diagnostic challenge of the newborn patients with heritable protein C deficiency

Cerebral venous sinus thrombosis

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