Outcome of Noncatheter-Related Thrombosis in Children: Influence of Underlying or Coexisting Factors

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Abstract
To determine the hereditary and nonhereditary risk factors contributing to the development of noncatheter-related thrombosis in children. Ninety-five children with noncatheter-related thrombosis from a single center were analyzed for clinical manifestations and outcome during a period of 3.5 years. Patients with thrombosis were evaluated for congenital and acquired risk factors, and patients were screened for factor V Leiden, prothrombin 20210A mutations, protein C, protein S, antithrombin III deficiencies, and antiphospholipid antibodies. Twelve patients (12.5%) died of thrombosis that was associated with a nonmalignant underlying disorder, and 19 patients (20%) had significant complications, including amputation of extremities, epilepsy, hemiplegia, portal hypertension, recurrence of deep vein thrombosis, and postphlebitic syndrome. Two common mutations (factor V Leiden and prothrombin 20210A) were found in 32.5% of the patients with thrombosis. The most frequent underlying disorder was infection (68%). Ninety-three patients (98%) had one or more risk factors. The coexistence of an underlying disorder and the presence of predisposing factors such as infection and the factor V Leiden mutation may cause high rates of death and complications in children with noncatheter-related thrombosis. The results of this study indicate that the underlying disorder and the site of thrombosis determine the rates of death and complications in children with thrombosis.