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Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1999 Aug;81(2):176–178. doi: 10.1136/adc.81.2.176

Congenital thrombophilia and thrombosis: a study in a single centre

S Lawson 1, D Butler 1, M Enayat 1, M Williams 1
PMCID: PMC1718022  PMID: 10490533

Abstract

AIM—To identify the incidence of congenital thrombophilia in a cohort of children presenting with symptomatic thromboembolism.
METHOD—A review of children with thromboembolism investigated for thrombophilia over a 12 month period.
SUBJECTS—Thirty children with thromboembolic episodes and 16 of their family members.
MEASUREMENTS AND DATA COLLECTION—Data were collected on age at diagnosis, underlying diagnosis, site of thrombosis, associated precipitating factors, occurrence of other thromboembolic events, and family history. Investigations included measurement of protein C activity, total and free protein S antigen, antithrombin III activity, screening for factor V Leiden and prothrombin 20210A, urinary homocysteine estimation, and a screen for lupus anticoagulant.
RESULTS—Twenty seven of 30 patients had one or more risk factors present at the time of thromboembolism. Eighty three per cent had acquired precipitating factors present, and 43% had underlying congenital thrombophilia.
CONCLUSIONS—There was a high incidence of congenital thrombophilia in this group of patients with symptomatic thromboembolism. These findings emphasise the importance of such defects in the pathogenesis of childhood thrombosis, and suggest that full thrombophilia investigations should be performed on all children presenting with thromboembolic disease.



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Selected References

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  1. Andrew M., David M., Adams M., Ali K., Anderson R., Barnard D., Bernstein M., Brisson L., Cairney B., DeSai D. Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE. Blood. 1994 Mar 1;83(5):1251–1257. [PubMed] [Google Scholar]
  2. Andrew M., Vegh P., Johnston M., Bowker J., Ofosu F., Mitchell L. Maturation of the hemostatic system during childhood. Blood. 1992 Oct 15;80(8):1998–2005. [PubMed] [Google Scholar]
  3. Dahlbäck B., Carlsson M., Svensson P. J. Familial thrombophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein C: prediction of a cofactor to activated protein C. Proc Natl Acad Sci U S A. 1993 Feb 1;90(3):1004–1008. doi: 10.1073/pnas.90.3.1004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. David M., Andrew M. Venous thromboembolic complications in children. J Pediatr. 1993 Sep;123(3):337–346. doi: 10.1016/s0022-3476(05)81730-5. [DOI] [PubMed] [Google Scholar]
  5. Ehrenforth S., Ludwig G., Klinke S., Krause M., Scharrer I., Nowak-Gottl U. The prothrombin 20210 A allele is frequently coinherited in young carriers of the factor V Arg 506 to Gln mutation with venous thrombophilia. Blood. 1998 Mar 15;91(6):2209–2210. [PubMed] [Google Scholar]
  6. Enayat M. S., Williams M. D., Hill F. G. Further simplifications of the factor V: Q506 mutation detection test. Blood Coagul Fibrinolysis. 1997 Apr;8(3):205–205. doi: 10.1097/00001721-199704000-00009. [DOI] [PubMed] [Google Scholar]
  7. Gandrille S., Greengard J. S., Alhenc-Gelas M., Juhan-Vague I., Abgrall J. F., Jude B., Griffin J. H., Aiach M. Incidence of activated protein C resistance caused by the ARG 506 GLN mutation in factor V in 113 unrelated symptomatic protein C-deficient patients. The French Network on the behalf of INSERM. Blood. 1995 Jul 1;86(1):219–224. [PubMed] [Google Scholar]
  8. Koeleman B. P., Reitsma P. H., Allaart C. F., Bertina R. M. Activated protein C resistance as an additional risk factor for thrombosis in protein C-deficient families. Blood. 1994 Aug 15;84(4):1031–1035. [PubMed] [Google Scholar]
  9. Makris M., Preston F. E., Beauchamp N. J., Cooper P. C., Daly M. E., Hampton K. K., Bayliss P., Peake I. R., Miller G. J. Co-inheritance of the 20210A allele of the prothrombin gene increases the risk of thrombosis in subjects with familial thrombophilia. Thromb Haemost. 1997 Dec;78(6):1426–1429. [PubMed] [Google Scholar]
  10. Nowak-Göttl U., Dübbers A., Kececioglu D., Koch H. G., Kotthoff S., Runde J., Vielhaber H. Factor V Leiden, protein C, and lipoprotein (a) in catheter-related thrombosis in childhood: a prospective study. J Pediatr. 1997 Oct;131(4):608–612. doi: 10.1016/s0022-3476(97)70071-4. [DOI] [PubMed] [Google Scholar]
  11. Nuss R., Hays T., Manco-Johnson M. Childhood thrombosis. Pediatrics. 1995 Aug;96(2 Pt 1):291–294. [PubMed] [Google Scholar]
  12. Poort S. R., Rosendaal F. R., Reitsma P. H., Bertina R. M. A common genetic variation in the 3'-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood. 1996 Nov 15;88(10):3698–3703. [PubMed] [Google Scholar]
  13. Rosendaal F. R. Thrombosis in the young: epidemiology and risk factors. A focus on venous thrombosis. Thromb Haemost. 1997 Jul;78(1):1–6. [PubMed] [Google Scholar]
  14. Seligsohn U., Zivelin A. Thrombophilia as a multigenic disorder. Thromb Haemost. 1997 Jul;78(1):297–301. [PubMed] [Google Scholar]
  15. Sifontes M. T., Nuss R., Hunger S. P., Wilimas J., Jacobson L. J., Manco-Johnson M. J. The factor V Leiden mutation in children with cancer and thrombosis. Br J Haematol. 1997 Mar;96(3):484–489. doi: 10.1046/j.1365-2141.1997.d01-2046.x. [DOI] [PubMed] [Google Scholar]
  16. Sifontes M. T., Nuss R., Jacobson L. J., Griffin J. H., Manco-Johnson M. J. Thrombosis in otherwise well children with the factor V Leiden mutation. J Pediatr. 1996 Mar;128(3):324–328. doi: 10.1016/s0022-3476(96)70275-5. [DOI] [PubMed] [Google Scholar]
  17. Zoller B., Svensson P. J., Dahlback B., Hillarp A. The A20210 allele of the prothrombin gene is frequently associated with the factor V Arg 506 to Gln mutation but not with protein S deficiency in thrombophilic families. Blood. 1998 Mar 15;91(6):2210–2211. [PubMed] [Google Scholar]
  18. Zöller B., Berntsdotter A., García de Frutos P., Dahlbäck B. Resistance to activated protein C as an additional genetic risk factor in hereditary deficiency of protein S. Blood. 1995 Jun 15;85(12):3518–3523. [PubMed] [Google Scholar]
  19. van Boven H. H., Reitsma P. H., Rosendaal F. R., Bayston T. A., Chowdhury V., Bauer K. A., Scharrer I., Conard J., Lane D. A. Factor V Leiden (FV R506Q) in families with inherited antithrombin deficiency. Thromb Haemost. 1996 Mar;75(3):417–421. [PubMed] [Google Scholar]

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