Thrombophilia testing in children: A 7 year experience

A. Mahajerin, P. Obasaju, G. Eckert, Terry Vik, Rakesh Mehta, M. Heiny

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Incidence of venous thromboembolism (VTE) in children is reported to be increasing. We examined thrombophilia testing results in children with VTE that presented in inpatient and outpatient settings to explore patterns of thrombophilia testing. Procedure: Patients/Methods: Children, ages 0-20 years with VTE seen at our institution from Jan 2005 to Apr 2012 were studied retrospectively. All patients with VTE confirmed by imaging were eligible and the presence of significant risk factors was evaluated. Thrombophilia was diagnosed if >1 tests confirmed: persistently low protein C (PC), protein S (PS), and antithrombin (AT) following VTE resolution, persistent antiphospholipid antibodies (APA) positivity >12 weeks from first test, factor V Leiden (FVL) and prothrombin mutation (PTm) hetero- or homozygosity, elevated plasminogen activator inhibitor (PAI-1) levels with 4G/5G or 4G/4G polymorphisms, methylene tetrahydrofolate reductase (MTHFR) polymorphisms with elevated fasting homocysteine levels. Results: Three hundred ninety-two patients met inclusion criteria. At least one test was ordered in 157/239 inpatients. All 153 outpatients had >1 test ordered. Thrombophilia rate differences between inpatients and outpatients did not reach statistical significance except for PC deficiency, which was significantly higher in outpatients. Of inpatients, central venous line (CVL) was significantly associated with not having tests done (P<0.0022). Conclusions: This study of pediatric VTE demonstrated a low thrombophilia rate in both inpatient and outpatient populations. The role of testing in other pediatric patients should be further explored.

Original languageEnglish
Pages (from-to)523-527
Number of pages5
JournalPediatric Blood and Cancer
Volume61
Issue number3
DOIs
StatePublished - Mar 2014

Fingerprint

Thrombophilia
Venous Thromboembolism
Inpatients
Outpatients
Plasminogen Activator Inhibitor 1
Protein C Deficiency
Pediatrics
Methylenetetrahydrofolate Reductase (NADPH2)
Antiphospholipid Antibodies
Antithrombins
Protein S
Prothrombin
Homocysteine
Protein C
Fasting
Mutation
Incidence
Population

Keywords

  • Pediatric hematology/oncology
  • Thrombophilia
  • Thrombosis

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Thrombophilia testing in children : A 7 year experience. / Mahajerin, A.; Obasaju, P.; Eckert, G.; Vik, Terry; Mehta, Rakesh; Heiny, M.

In: Pediatric Blood and Cancer, Vol. 61, No. 3, 03.2014, p. 523-527.

Research output: Contribution to journalArticle

Mahajerin, A, Obasaju, P, Eckert, G, Vik, T, Mehta, R & Heiny, M 2014, 'Thrombophilia testing in children: A 7 year experience', Pediatric Blood and Cancer, vol. 61, no. 3, pp. 523-527. https://doi.org/10.1002/pbc.24846
Mahajerin, A. ; Obasaju, P. ; Eckert, G. ; Vik, Terry ; Mehta, Rakesh ; Heiny, M. / Thrombophilia testing in children : A 7 year experience. In: Pediatric Blood and Cancer. 2014 ; Vol. 61, No. 3. pp. 523-527.
@article{fef937323f9445baa5b8fa658e5e030a,
title = "Thrombophilia testing in children: A 7 year experience",
abstract = "Background: Incidence of venous thromboembolism (VTE) in children is reported to be increasing. We examined thrombophilia testing results in children with VTE that presented in inpatient and outpatient settings to explore patterns of thrombophilia testing. Procedure: Patients/Methods: Children, ages 0-20 years with VTE seen at our institution from Jan 2005 to Apr 2012 were studied retrospectively. All patients with VTE confirmed by imaging were eligible and the presence of significant risk factors was evaluated. Thrombophilia was diagnosed if >1 tests confirmed: persistently low protein C (PC), protein S (PS), and antithrombin (AT) following VTE resolution, persistent antiphospholipid antibodies (APA) positivity >12 weeks from first test, factor V Leiden (FVL) and prothrombin mutation (PTm) hetero- or homozygosity, elevated plasminogen activator inhibitor (PAI-1) levels with 4G/5G or 4G/4G polymorphisms, methylene tetrahydrofolate reductase (MTHFR) polymorphisms with elevated fasting homocysteine levels. Results: Three hundred ninety-two patients met inclusion criteria. At least one test was ordered in 157/239 inpatients. All 153 outpatients had >1 test ordered. Thrombophilia rate differences between inpatients and outpatients did not reach statistical significance except for PC deficiency, which was significantly higher in outpatients. Of inpatients, central venous line (CVL) was significantly associated with not having tests done (P<0.0022). Conclusions: This study of pediatric VTE demonstrated a low thrombophilia rate in both inpatient and outpatient populations. The role of testing in other pediatric patients should be further explored.",
keywords = "Pediatric hematology/oncology, Thrombophilia, Thrombosis",
author = "A. Mahajerin and P. Obasaju and G. Eckert and Terry Vik and Rakesh Mehta and M. Heiny",
year = "2014",
month = "3",
doi = "10.1002/pbc.24846",
language = "English",
volume = "61",
pages = "523--527",
journal = "Pediatric Blood and Cancer",
issn = "1545-5009",
publisher = "Wiley-Liss Inc.",
number = "3",

}

TY - JOUR

T1 - Thrombophilia testing in children

T2 - A 7 year experience

AU - Mahajerin, A.

AU - Obasaju, P.

AU - Eckert, G.

AU - Vik, Terry

AU - Mehta, Rakesh

AU - Heiny, M.

PY - 2014/3

Y1 - 2014/3

N2 - Background: Incidence of venous thromboembolism (VTE) in children is reported to be increasing. We examined thrombophilia testing results in children with VTE that presented in inpatient and outpatient settings to explore patterns of thrombophilia testing. Procedure: Patients/Methods: Children, ages 0-20 years with VTE seen at our institution from Jan 2005 to Apr 2012 were studied retrospectively. All patients with VTE confirmed by imaging were eligible and the presence of significant risk factors was evaluated. Thrombophilia was diagnosed if >1 tests confirmed: persistently low protein C (PC), protein S (PS), and antithrombin (AT) following VTE resolution, persistent antiphospholipid antibodies (APA) positivity >12 weeks from first test, factor V Leiden (FVL) and prothrombin mutation (PTm) hetero- or homozygosity, elevated plasminogen activator inhibitor (PAI-1) levels with 4G/5G or 4G/4G polymorphisms, methylene tetrahydrofolate reductase (MTHFR) polymorphisms with elevated fasting homocysteine levels. Results: Three hundred ninety-two patients met inclusion criteria. At least one test was ordered in 157/239 inpatients. All 153 outpatients had >1 test ordered. Thrombophilia rate differences between inpatients and outpatients did not reach statistical significance except for PC deficiency, which was significantly higher in outpatients. Of inpatients, central venous line (CVL) was significantly associated with not having tests done (P<0.0022). Conclusions: This study of pediatric VTE demonstrated a low thrombophilia rate in both inpatient and outpatient populations. The role of testing in other pediatric patients should be further explored.

AB - Background: Incidence of venous thromboembolism (VTE) in children is reported to be increasing. We examined thrombophilia testing results in children with VTE that presented in inpatient and outpatient settings to explore patterns of thrombophilia testing. Procedure: Patients/Methods: Children, ages 0-20 years with VTE seen at our institution from Jan 2005 to Apr 2012 were studied retrospectively. All patients with VTE confirmed by imaging were eligible and the presence of significant risk factors was evaluated. Thrombophilia was diagnosed if >1 tests confirmed: persistently low protein C (PC), protein S (PS), and antithrombin (AT) following VTE resolution, persistent antiphospholipid antibodies (APA) positivity >12 weeks from first test, factor V Leiden (FVL) and prothrombin mutation (PTm) hetero- or homozygosity, elevated plasminogen activator inhibitor (PAI-1) levels with 4G/5G or 4G/4G polymorphisms, methylene tetrahydrofolate reductase (MTHFR) polymorphisms with elevated fasting homocysteine levels. Results: Three hundred ninety-two patients met inclusion criteria. At least one test was ordered in 157/239 inpatients. All 153 outpatients had >1 test ordered. Thrombophilia rate differences between inpatients and outpatients did not reach statistical significance except for PC deficiency, which was significantly higher in outpatients. Of inpatients, central venous line (CVL) was significantly associated with not having tests done (P<0.0022). Conclusions: This study of pediatric VTE demonstrated a low thrombophilia rate in both inpatient and outpatient populations. The role of testing in other pediatric patients should be further explored.

KW - Pediatric hematology/oncology

KW - Thrombophilia

KW - Thrombosis

UR - http://www.scopus.com/inward/record.url?scp=84892537259&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892537259&partnerID=8YFLogxK

U2 - 10.1002/pbc.24846

DO - 10.1002/pbc.24846

M3 - Article

C2 - 24249220

AN - SCOPUS:84892537259

VL - 61

SP - 523

EP - 527

JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

IS - 3

ER -