Document Detail


Cerebral venous thrombosis in children: a multifactorial origin.
MedLine Citation:
PMID:  12939214     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The present study was performed to assess the association of prothrombotic risk factors and underlying conditions (infections, vascular trauma, immobilization, malignancies, autoimmune diseases, renal diseases, metabolic disorders, obesity, birth asphyxia, cardiac malformations, and use of prothrombotic drugs) with cerebral venous thrombosis (CVT) in children. METHODS AND RESULTS: From 1995 to 2002, 149 pediatric patients aged newborn to <18 years (median 6 years) with CVT were consecutively enrolled. In patients and in 149 age- and gender-matched children with similar underlying clinical conditions but without CVT, the factor V G1691A mutation, the factor II G20210A variant, lipoprotein(a) [Lp(a)], protein C, protein S, antithrombin, and antiphospholipid antibodies, as well as associated clinical conditions, were investigated. Eighty-four (56.4%) of the patients had at least 1 prothrombotic risk factor compared with 31 control children (20.8%; P<0.0001). In addition, 105 (70.5%) of 149 patients with CVT presented with an underlying predisposing condition. On univariate analysis, factor V, protein C, protein S, and elevated Lp(a) were found to be significantly associated with CVT. However, in multivariate analysis, only the combination of a prothrombotic risk factor with an underlying condition (OR 3.9, 95% CI 1.8 to 8.6), increased Lp(a) (OR 4.1, 95% CI 2.0 to 8.7), and protein C deficiency (OR 11.1, 95% CI 1.2 to 104.4) had independent associations with CVT in the children investigated. CONCLUSIONS: CVT in children is a multifactorial disease that, in the majority of cases, results from a combination of prothrombotic risk factors and/or underlying clinical condition.
Authors:
Christine Heller; Achim Heinecke; Ralf Junker; Ralf Knöfler; Andrea Kosch; Karin Kurnik; Rosemarie Schobess; Arnold von Eckardstein; Ronald Sträter; Barbara Zieger; Ulrike Nowak-Göttl;
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2003-08-25
Journal Detail:
Title:  Circulation     Volume:  108     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-16     Completed Date:  2003-09-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1362-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics/Pediatric Hematology & Oncology, University of Frankfurt am Main, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cerebral Veins*
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Intracranial Thrombosis / diagnosis,  etiology*
Male
Risk Factors
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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