Download PDF
Semin Thromb Hemost 2003; 29(4): 391-404
DOI: 10.1055/s-2003-42589
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Venous Thromboembolic Disease in Childhood

C. Heleen van Ommen1 , Marjolein Peters2
  • 1Professor, Department of Pediatric Hematology Emma Children's Hospital AMC Amsterdam, The Netherlands
  • 2Department of Pediatric Hematology Emma Children's Hospital AMC Amsterdam, The Netherlands
Further Information

Publication History

Publication Date:
30 September 2003 (online)

    Permissions and Reprints

ABSTRACT

Venous thrombosis is an uncommon disorder in childhood with an incidence of about 1 in 100,000 children (ages 0 to 18 years). Multiple clinical underlying conditions as well as congenital prothrombotic disorders contribute to the development of pediatric venous thromboembolic disease. The majority of thrombi are catheter-related and therefore situated in the upper venous system. Diagnosis of thrombosis in either the upper or lower venous system is most frequently made by noninvasive radiographic techniques, especially ultrasonography. Children are treated according to recommendations based on small pediatric studies and guidelines adapted from adult patient protocols. The long-term complications, including mortality, recurrence, and the post-thrombotic syndrome, seem to be considerable. Because the incidence of pediatric venous thrombosis will probably rise due to the increased use of central venous catheters and the increased survival of children with chronic diseases associated with a prothrombotic state, prevention of this disease will become an important issue.

KEYWORDS

Thrombosis - pediatrics - thrombophilia - anticoagulation - outcome

REFERENCES

  • 1 Nordström M, Lindblad B, Bergqvist D, Kjellström T. A prospective study of the incidence of deep-vein thrombosis within a defined urban population.  J Intern Med . 1992;  232 155-160
    PubMedGoogle Scholar
  • 2 Andrew M, David M, Adams M. et al . Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE.  Blood . 1994;  83 1251-1257
    CrossrefPubMedGoogle Scholar
  • 3 van Ommen H C, Heijboer H, Büller H R, Hirasing R A, Heijmans H SA, Peters M. Venous thromboembolism in childhood: a prospective two-year registry in The Netherlands.  J Pediatr . 2001;  139 676-681
    CrossrefPubMedGoogle Scholar
  • 4 Nowak-Göttl U, von Kries R, Göbel U. Neonatal symptomatic thromboembolism in Germany: two year survey.  Arch Dis Child Fetal Neonatal Ed . 1997;  76 F163-F167
    CrossrefPubMedGoogle Scholar
  • 5 Byard R W, Cutz E. Sudden and unexpected death in infancy and childhood due to pulmonary thromboembolism. An autopsy study.  Arch Pathol Lab Med . 1990;  114 142-144
    PubMedGoogle Scholar
  • 6 Jones R H, Sabiston D CJ. Pulmonary embolism in childhood.  Monogr Surg Sci . 1966;  3 35-51
    PubMedGoogle Scholar
  • 7 Marsh D, Wilkerson S A, Cook L N, Pietsch J B. Right atrial thrombus formation screening using two-dimensional echocardiograms in neonates with central venous catheters.  Pediatrics . 1988;  81 284-286
    PubMedGoogle Scholar
  • 8 Mehta S, Connors A FJ, Danish E H, Grisoni E. Incidence of thrombosis during central venous catheterization of newborns: a prospective study.  J Pediatr Surg . 1992;  27 18-22
    CrossrefPubMedGoogle Scholar
  • 9 Tanke R B, Van Megen R, Daniëls O. Thrombus detection on central venous catheters in the neonatal intensive care unit.  Angiology . 1994;  45 477-480
    PubMedGoogle Scholar
  • 10 Wever M LG, Liem K D, Geven W B, Tanke R B. Urokinase therapy in neonates with catheter related central venous thrombosis.  Thromb Haemost . 1995;  73 180-185
    PubMedGoogle Scholar
  • 11 Roy M, Turner-Gomes S, Gill G, Way C, Mernagh J, Schmidt B. Accuracy of Doppler echocardiography for the diagnosis of thrombosis associated with umbilical venous catheters.  J Pediatr . 2002;  140 131-134
    CrossrefPubMedGoogle Scholar
  • 12 Krafte-Jacobs B, Sivit C J, Mejia R, Pollack M M. Catheter-related thrombosis in critically ill children: comparison of catheters with and without heparin bonding.  J Pediatr . 1995;  126 50-54
    PubMedGoogle Scholar
  • 13 Shefler A, Gillis J, Lam A, O'Connell A J, Schell D, Lammi A. Inferior vena cava thrombosis as a complication of femoral vein catheterisation.  Arch Dis Child . 1995;  72 343-345
    CrossrefPubMedGoogle Scholar
  • 14 Talbott G A, Winters W D, Bratton S L, O'Rourke P P. A prospective study of femoral catheter-related thrombosis in children.  Arch Pediatr Adolesc Med . 1995;  149 288-291
    PubMedGoogle Scholar
  • 15 Glaser D W, Medeiros D, Rollins N, Buchanan G R. Catheter-related thrombosis in children with cancer.  J Pediatr . 2001;  138 255-259
    CrossrefPubMedGoogle Scholar
  • 16 Virchow R. Phlogose und Thrombose im Gefässsystem. In: Virchow R, ed. Gesammelte Abhandlungen zur Wissenschaftlichen Medizin Frankfurt, Germany: Von Meidinger Sohn 1856: 458-636
    Google Scholar
  • 17 Monagle P, Adams M, Mahoney M. et al . Outcome of pediatric thromboembolic disease: a report from the Canadian Childhood Thrombophilia Registry.  Pediatr Res . 2000;  47 763-766
    CrossrefPubMedGoogle Scholar
  • 18 Gurgey A, Aslan D. Outcome of noncatheter-related thrombosis in children: influence of underlying or coexisting factors.  J Pediatr Hematol Oncol . 2001;  23 159-164
    CrossrefPubMedGoogle Scholar
  • 19 Schmidt B, Andrew M. Neonatal thrombosis: report of a prospective Canadian and international registry.  Pediatrics . 1995;  96 939-943
    PubMedGoogle Scholar
  • 20 Conte F A, Grumbach M M. Estrogen use in children and adolescents: a survey.  Pediatrics . 1978;  62 1091-1097
    PubMedGoogle Scholar
  • 21 Weimann E, Brack C. Severe thrombosis during treatment with ethinylestradiol for tall stature.  Horm Res . 1996;  45 261-263
    PubMedGoogle Scholar
  • 22 Werder E A, Waibel P, Sege D, Flury R. Severe thrombosis during oestrogen treatment for tall stature.  Eur J Pediatr . 1990;  149 389-390
    PubMedGoogle Scholar
  • 23 Wettenhall H N, Cahill C, Roche A F. Tall girls: a survey of 15 years of management and treatment.  J Pediatr . 1975;  86 602-610
    PubMedGoogle Scholar
  • 24 van Ommen H C, Fijnvandraat K, Vulsma T, Delemarre-Van De Waal A H, Peters M. Acquired protein S deficiency caused by estrogen treatment of tall stature.  J Pediatr . 1999;  135 477-481
    PubMedGoogle Scholar
  • 25 Al-Ismail S, Collins P, Najib R, James-Ellison M, O'Hagan M. Postinfection purpura fulminans in a patient heterozygous for prothrombin G20210A and acquired protein S resistance.  Pediatr Hematol Oncol . 1999;  16 561-564
    CrossrefPubMedGoogle Scholar
  • 26 D'Angelo A, Della Valle P, Crippa L, Pattarini E, Grimaldi L M, D'Angelo S V. Brief report: autoimmune protein S deficiency in a boy with severe thromboembolic disease.  N Engl J Med . 1993;  328 1753-1757
    CrossrefPubMedGoogle Scholar
  • 27 Josephson C, Nuss R, Jacobson L. et al . The varicella-autoantibody syndrome.  Pediatr Res . 2001;  50 345-352
    CrossrefPubMedGoogle Scholar
  • 28 Levin M, Eley B S, Louis J, Cohen H, Young L, Heyderman R S. Postinfectious purpura fulminans caused by an autoantibody directed against protein S.  J Pediatr . 1995;  127 355-363
    PubMedGoogle Scholar
  • 29 Manco-Johnson M J, Nuss R, Key N. et al . Lupus anticoagulant and protein S deficiency in children with postvaricella purpura fulminans or thrombosis.  J Pediatr . 1996;  128 319-323
    CrossrefPubMedGoogle Scholar
  • 30 van Ommen H C, Van Wijnen M, De Groot G F, Van Der Horst C A M M, Peters M. Postvaricella purpura fulminans caused by acquired protein S deficiency resulting from antiprotein S antibodies: search for the epitopes.  J Pediatr Hematol Oncol . 2002;  24 413-416
    CrossrefPubMedGoogle Scholar
  • 31 Schlegel N. Thromboembolic risks and complications in nephrotic children.  Semin Thromb Hemost . 1997;  23 271-280
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Hoyer P F, Gonda S, Barthels M, Krohn H P, Brodehl J. Thromboembolic complications in children with nephrotic syndrome. Risk and incidence.  Acta Paediatr Scand . 1986;  75 804-810
    PubMedGoogle Scholar
  • 33 Fiumara A, Barone R, Buttitta P. et al . Haemostatic studies in carbohydrate-deficient glycoprotein syndrome type I.  Thromb Haemost . 1996;  76 502-504
    PubMedGoogle Scholar
  • 34 Iijima K, Murakami F, Nakamura K. et al . Hemostatic studies in patients with carbohydrate-deficient glycoprotein syndrome.  Thromb Res . 1994;  76 193-198
    CrossrefPubMedGoogle Scholar
  • 35 Okamoto N, Wada Y, Kobayashi M. et al . Decreased blood coagulation activities in carbohydrate-deficient glycoprotein syndrome.  J Inherit Metab Dis . 1993;  16 435-440
    CrossrefPubMedGoogle Scholar
  • 36 Van Geet C, Jaeken J. A unique pattern of coagulation abnormalities in carbohydrate-deficient glycoprotein syndrome.  Pediatr Res . 1993;  33 540-541
    PubMedGoogle Scholar
  • 37 Stibler H, Jaeken J, Kristiansson B. Biochemical characteristics and diagnosis of the carbohydrate-deficient glycoprotein syndrome.  Acta Paediatr Scand Suppl . 1991;  375 21-31
    PubMedGoogle Scholar
  • 38 Young G, Driscoll M C. Coagulation abnormalities in the carbohydrate-deficient glycoprotein syndrome: case report and review of the literature.  Am J Hematol . 1999;  60 66-69
    CrossrefPubMedGoogle Scholar
  • 39 Funk M, Becker S, Pötzsch B, Kreuz W, Böhles H. Thrombophilia in a child with CDG-syndrome type I.  Thromb Haemost . 1995;  74 1199-1200
    PubMedGoogle Scholar
  • 40 Jaeken J, Matthijs G, Carchon H, Van Schaftingen E. Defects of n-glycan synthesis. In: Scriver CR, Beandet AL, Sly WS, Valle D, eds. The Metabolic and Molecular Bases of Inherited Disease New York, NY: McGraw-Hill 2001 : 1601-1622
    Google Scholar
  • 41 Stibler H, Holzbach U, Tengborn L, Kristiansson B. Complex functional and structural coagulation abnormalities in the carbohydrate-deficient glycoprotein syndrome type I.  Blood Coagul Fibrinolysis . 1996;  7 118-126
    PubMedGoogle Scholar
  • 42 Cromme-Dijkhuis A H, Henkens C M, Bijleveld C M, Hillege H L, Bom V J, Van Der Meer J. Coagulation factor abnormalities as possible thrombotic risk factors after Fontan operations.  Lancet . 1990;  336 1087-1090
    CrossrefPubMedGoogle Scholar
  • 43 Jahangiri M, Shore D, Kakkar V, Lincoln C, Shinebourne E. Coagulation factor abnormalities after the Fontan procedure and its modifications.  J Thorac Cardiovasc Surg . 1997;  113 989-992
    CrossrefPubMedGoogle Scholar
  • 44 van Nieuwenhuizen C R, Peters M, Lubbers L J, Trip M D, Tijssen J G, Mulder B J. Abnormalities in liver function and coagulation profile following the Fontan procedure.  Heart . 1999;  82 40-46
    PubMedGoogle Scholar
  • 45 Jahangiri M, Ross D B, Redington A N, Lincoln C, Shinebourne E A. Thromboembolism after the Fontan procedure and its modifications.  Ann Thorac Surg . 1994;  58 1409-1413
    PubMedGoogle Scholar
  • 46 Monagle P, Karl T R. Thromboembolic problems after the Fontan operation.  Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu . 2002;  5 36-47
    PubMedGoogle Scholar
  • 47 Lane D A, Mannucci P M, Bauer K A. et al . Inherited thrombophilia: part 1.  Thromb Haemost . 1996;  76 651-662
    PubMedGoogle Scholar
  • 48 Rosendaal F R. Venous thrombosis: a multicausal disease.  Lancet . 1999;  353 1167-1173
    CrossrefPubMedGoogle Scholar
  • 49 Bonduel M, Hepner M, Sciuccati G, Torres A F, Pieroni G, Frontroth J P. Prothrombotic abnormalities in children with venous thromboembolism.  J Pediatr Hematol Oncol . 2000;  22 66-72
    CrossrefPubMedGoogle Scholar
  • 50 Bonduel M, Hepner M, Sciuccati G. et al . Factor V Leiden and prothrombin gene G20210A mutation in children with venous thromboembolism.  Thromb Haemost . 2002;  87 972-977
    PubMedGoogle Scholar
  • 51 Ehrenforth S, Junker R, Koch H G. et al . Multicentre evaluation of combined prothrombotic defects associated with thrombophilia in childhood. Childhood Thrombophilia Study Group.  Eur J Pediatr . 1999;  158(Suppl 3) S97-104
    CrossrefPubMedGoogle Scholar
  • 52 Junker R, Koch H G, Auberger K, Münchow N, Ehrenforth S, Nowak-Göttl U. Prothrombin G20210A gene mutation and further prothrombotic risk factors in childhood thrombophilia.  Arterioscler Thromb Vasc Biol . 1999;  19 2568-2572
    PubMedGoogle Scholar
  • 53 Kosch A, Junker R, Kurnik K. et al . Prothrombotic risk factors in children with spontaneous venous thrombosis and their asymptomatic parents: a family study.  Thromb Res . 2000;  99 531-537
    CrossrefPubMedGoogle Scholar
  • 54 Lawson S E, Butler D, Enayat M S, Williams M D. Congenital thrombophilia and thrombosis: a study in a single centre.  Arch Dis Child . 1999;  81 176-178
    PubMedGoogle Scholar
  • 55 Nowak-Göttl U, Junker R, Kreuz W. et al . Risk of recurrent venous thrombosis in children with combined prothrombotic risk factors.  Blood . 2001;  97 858-862
    CrossrefPubMedGoogle Scholar
  • 56 Salonvaara M, Riikonen P, Kekomäki R, Heinonen K. Clinically symptomatic central venous catheter-related deep venous thrombosis in newborns.  Acta Paediatr . 1999;  88 642-646
    CrossrefPubMedGoogle Scholar
  • 57 Schobess R, Junker R, Auberger K, Münchow N, Budach S, Nowak-Göttl U. Factor V G1691A and prothrombin G20210A in childhood spontaneous venous thrombosis-evidence of an age-dependent thrombotic onset in carriers of factor V G1691A and prothrombin G20210A mutation.  Eur J Pediatr . 1999;  158(Suppl 3) S105-S108
    PubMedGoogle Scholar
  • 58 Cattaneo M. Hyperhomocysteinemia and thrombosis.  Lipids . 2001;  36(Suppl) S13-S26
    PubMedGoogle Scholar
  • 59 Libourel E J, Bank I, Meinardi J R. et al . Co-segregation of thrombophilic disorders in factor V Leiden carriers; the contributions of factor VIII, factor XI, thrombin activatable fibrinolysis inhibitor and lipoprotein(a) to the absolute risk of venous thromboembolism.  Haematologica . 2002;  87 1068-1073
    PubMedGoogle Scholar
  • 60 Meijers J CM, Tekelenburg W LH, Bouma B N, Bertina R M, Rosendaal F R. High levels of coagulation factor XI as a risk factor for venous thrombosis.  N Engl J Med . 2000;  342 696-701
    CrossrefPubMedGoogle Scholar
  • 61 Nowak-Göttl U, Junker R, Hartmeier M. et al . Increased lipoprotein(a) is an important risk factor for venous thromboembolism in childhood.  Circulation . 1999;  100 747-748
    PubMedGoogle Scholar
  • 62 Tsai A W, Cushman M, Rosamond W D. et al . Coagulation factors, inflammation markers, and venous thromboembolism: the longitudinal investigation of thromboembolism etiology (LITE).  Am J Med . 2002;  113 636-642
    CrossrefPubMedGoogle Scholar
  • 63 Van Hylckama Vlieg A, van der Linden K I, Bertina R M, Rosendaal F R. High levels of factor IX increase the risk of venous thrombosis.  Blood . 2000;  95 3678-3682
    PubMedGoogle Scholar
  • 64 Van Tilburg H N, Rosendaal F R, Bertina R M. Thrombin activatable fibrinolysis inhibitor and the risk for deep vein thrombosis.  Blood . 2000;  95 2855-2859
    PubMedGoogle Scholar
  • 65 von Depka M, Nowak-Göttl U, Eisert R. et al . Increased lipoprotein(a) levels as an independent risk factor for venous thromboembolism.  Blood . 2000;  96 3364-3368
    CrossrefPubMedGoogle Scholar
  • 66 Manco-Johnson M J, Grabowski E F, Hellgreen M. et al . Laboratory testing for thrombophilia in pediatric patients. On behalf of the Subcommittee for Perinatal and Pediatric Thrombosis of the Scientific and Standardization Committee of the International Society of Thrombosis and Haemostasis (ISTH).  Thromb Haemost . 2002;  88 155-156
    PubMedGoogle Scholar
  • 67 Kearon C, Gent M, Hirsh J. et al . A comparison of three months of anticoagulation with extended anticoagulation for a first episode of idiopathic venous thromboembolism.  N Engl J Med . 1999;  340 901-907
    PubMedGoogle Scholar
  • 68 Agnelli G, Prandoni P, Santamaria M G. et al . Three months versus one year of oral anticoagulant therapy for idiopathic deep venous thrombosis. Warfarin Optimal Duration Italian Trial Investigators.  N Engl J Med . 2001;  345 165-169
    PubMedGoogle Scholar
  • 69 Monagle P, Michelson A D, Bovill E, Andrew M. Antithrombotic therapy in children.  Chest . 2001;  119 344S-370S
    CrossrefPubMedGoogle Scholar
  • 70 van Ommen C H. Venous Thromboembolic Disease in Childhood. Epidemiology, Risk Factors and Outcome [master's thesis]. Amsterdam, The Netherlands: Univ of Amsterdam; 2002: 103-113
  • 71 Tormene D, Simioni P, Prandoni P. et al . The incidence of venous thromboembolism in thrombophilic children: a prospective cohort study.  Blood . 2002;  100 2403-2405
    CrossrefPubMedGoogle Scholar
  • 72 Mulvihill S J, Fonkalsrud E W. Complications of superior versus inferior vena cava occlusion in infants receiving central total parenteral nutrition.  J Pediatr Surg . 1984;  19 752-757
    PubMedGoogle Scholar
  • 73 Beghetti M, La Scala G, Belli D, Bugmann P, Kalangos A, Le Coultre C. Etiology and management of pediatric chylothorax.  J Pediatr . 2000;  136 653-658
    CrossrefPubMedGoogle Scholar
  • 74 Campbell R M, Benson L N, Williams W W, Adatia I. Chylopericardium after cardiac operations in children.  Ann Thorac Surg . 2001;  72 193-196
    CrossrefPubMedGoogle Scholar
  • 75 Kurekci E, Kaye R, Koehler M. Chylothorax and chylopericardium: a complication of a central venous catheter.  J Pediatr . 1998;  132 1064-1066
    PubMedGoogle Scholar
  • 76 Massicotte M P, Dix D, Monagle P, Adams M, Andrew M. Central venous catheter-related thrombosis in children: analysis of the Canadian Registry of Venous Thromboembolic Complications.  J Pediatr . 1998;  133 770-776
    CrossrefPubMedGoogle Scholar
  • 77 Andrew M, Brooker L A. Hemostatic complications in renal disorders of the young.  Pediatr Nephrol . 1996;  10 88-99
    PubMedGoogle Scholar
  • 78 Bökenkamp A, von Kries R, Nowak-Göttl U, Göbel U, Hoyer P F. Neonatal renal venous thrombosis in Germany between 1992 and 1994; epidemiology, treatment and outcome.  Eur J Pediatr . 2000;  159 44-48
    CrossrefPubMedGoogle Scholar
  • 79 Mocan H, Beattie T J, Murphy A V. Renal venous thrombosis in infancy: long-term follow-up.  Pediatr Nephrol . 1991;  5 45-49
    CrossrefPubMedGoogle Scholar
  • 80 Branson H E, Katz J, Marble R, Griffin J H. Inherited protein C deficiency and coumarin-responsive chronic relapsing purpura fulminans in a newborn infant.  Lancet . 1983;  2 1165-1168
    PubMedGoogle Scholar
  • 81 Mahasandana C, Suvatte V, Chuansumrit A. et al . Homozygous protein S deficiency in an infant with purpura fulminans.  J Pediatr . 1990;  117 750-753
    CrossrefPubMedGoogle Scholar
  • 82 Baselga E, Drolet B A, Esterly N B. Purpura in infants and children.  J Am Acad Dermatol . 1997;  37 673-705
    PubMedGoogle Scholar
  • 83 Schwartz D S, Gettner P A, Konstantino M M. et al . Umbilical venous catheterization and the risk of portal vein thrombosis.  J Pediatr . 1997;  131 760-762
    PubMedGoogle Scholar
  • 84 Sieders E, Peeters P M, Tenvergert E M. et al . Early vascular complications after pediatric liver transplantation.  Liver Transplant . 2000;  6 326-332
    CrossrefPubMedGoogle Scholar
  • 85 van't Riet M, Burger J W, Van Muiswinkel M J, Kazemier G, Schipperus M R, Bonjer H J. Diagnosis and treatment of portal vein thrombosis following splenectomy.  Br J Surg . 2000;  87 1229-1233
    CrossrefPubMedGoogle Scholar
  • 86 Yamanaka J, Lynch S V, Ong T H. et al . Surgical complications and long-term outcome in pediatric liver transplantation.  Hepatogastroenterology . 2000;  47 1371-1374
    PubMedGoogle Scholar
  • 87 Barron T F, Gusnard D A, Zimmerman R A, Clancy R R. Cerebral venous thrombosis in neonates and children.  Pediatr Neurol . 1992;  8 112-116
    CrossrefPubMedGoogle Scholar
  • 88 Deveber G, Andrew M. Cerebral sinovenous thrombosis in children.  N Engl J Med . 2001;  345 417-423
    CrossrefPubMedGoogle Scholar
  • 89 Rivkin M J, Anderson M L, Kaye E M. Neonatal idiopathic cerebral venous thrombosis: an unrecognized cause of transient seizures or lethargy.  Ann Neurol . 1992;  32 51-56
    CrossrefPubMedGoogle Scholar
  • 90 Shevell M I, Silver K, O'Gorman A M, Watters G V, Montes J L. Neonatal dural sinus thrombosis.  Pediatr Neurol . 1989;  5 161-165
    CrossrefPubMedGoogle Scholar
  • 91 Derish M T, Smith D W, Frankel L R. Venous catheter thrombus formation and pulmonary embolism in children.  Pediatr Pulmonol . 1995;  20 349-354
    PubMedGoogle Scholar
  • 92 van Ommen H C, Heijboer H, Groothoff J W, Teeuw R, Aronson D C, Peters M. Persistent tachypnea in children: keep pulmonary embolism in mind.  J Pediatr Hematol Oncol . 1998;  20 570-573
    CrossrefPubMedGoogle Scholar
  • 93 Buck J R, Connors R H, Coon W W, Weintraub W H, Wesley J R, Coran A G. Pulmonary embolism in children.  J Pediatr Surg . 1981;  16 385-391
    CrossrefPubMedGoogle Scholar
  • 94 Bernstein D, Coupey S, Schonberg S K. Pulmonary embolism in adolescents.  Am J Dis Child . 1986;  140 667-671
    PubMedGoogle Scholar
  • 95 Desai M H, Linares H A, Herndon D N. Pulmonary embolism in burned children.  Burns . 1989;  15 376-380
    CrossrefPubMedGoogle Scholar
  • 96 Matthew D J, Levin M. Pulmonary thromboembolism in children.  Intensive Care Med . 1986;  12 404-406
    PubMedGoogle Scholar
  • 96a Lensing A W, Prandoni P, Brandjes D. et al . Detection of deep-vein thrombosis by real-time B-mode ultrasonography.  N Engl J Med . 1989;  320 342-345
    Google Scholar
  • 97 Male C, Chait P, Ginsberg J S. et al . Comparison of venography and ultrasound for the diagnosis of asymptomatic deep vein thrombosis in the upper body in children: results of the PARKAA study. Prophylactic antithrombin replacement in kids with ALL treated with asparaginase.  Thromb Haemost . 2002;  87 593-598
    PubMedGoogle Scholar
  • 98 Casey S O, Alberico R A, Patel M. et al . Cerebral CT venography.  Radiology . 1996;  198 163-170
    PubMedGoogle Scholar
  • 99 Connor S E, Jarosz J M. Magnetic resonance imaging of cerebral venous sinus thrombosis.  Clin Radiol . 2002;  57 449-461
    CrossrefPubMedGoogle Scholar
  • 100 Dormont D, Anxionnat R, Evrard S, Louaille C, Chiras J, Marsault C. MRI in cerebral venous thrombosis.  J Neuroradiol . 1994;  21 81-99
    PubMedGoogle Scholar
  • 101 Medlock M D, Olivero W C, Hanigan W C, Wright R M, Winek S J. Children with cerebral venous thrombosis diagnosed with magnetic resonance imaging and magnetic resonance angiography.  Neurosurgery . 1992;  31 870-876
    CrossrefPubMedGoogle Scholar
  • 102 Hull R D, Hirsh J, Carter C J. et al . Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan.  Ann Intern Med . 1983;  98 891-899
    CrossrefPubMedGoogle Scholar
  • 103 Mills S R, Jackson D C, Older R A, Heaston D K, Moore A V. The incidence, etiologies, and avoidance of complications of pulmonary angiography in a large series.  Radiology . 1980;  136 295-299
    PubMedGoogle Scholar
  • 104 van Strijen J M, De Monye W, Schiereck J. et al . Single-detector helical computed tomography as the primary diagnostic test in suspected pulmonary embolism: a multicenter clinical management study of 510 patients.  Ann Intern Med . 2003;  138 307-314
    PubMedGoogle Scholar
  • 105 Gleason M M, White M G, Myers J L. Echocardiographic diagnosis of pulmonary embolism in childhood.  J Am Soc Echocardiogr . 1995;  8 100-102
    PubMedGoogle Scholar
  • 106 Cheriex E C, Sreeram N, Eussen Y F, Pieters F AA, Wellens H JJ. Cross-sectional Doppler echocardiography as the initial technique for the diagnosis of acute pulmonary embolism.  Br Heart J . 1994;  72 52-57
    PubMedGoogle Scholar
  • 107 Häusler M, Hübner D, Delhaas T, Mühler E G. Long-term complications of inferior vena cava thrombosis.  Arch Dis Child . 2001;  85 228-233
    CrossrefPubMedGoogle Scholar
  • 108 Massicotte M P, Dix D, Monagle P, Adams M, Andrew M. Central venous catheter related thrombosis in children: analysis of the Canadian Registry of Venous Thromboembolic Complications.  J Pediatr . 1998;  133 770-776
    CrossrefPubMedGoogle Scholar
  • 109 Monagle P, Adams M, Mahoney M. et al . Outcome of pediatric thromboembolic disease: a report from the Canadian Childhood Thrombophilia Registry.  Pediatr Res . 2000;  47 763-766
    CrossrefPubMedGoogle Scholar
  • 110 Heit J A, Mohr D N, Silverstein M D, Petterson T M, O'Fallon W M, Melton III J L. Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study.  Arch Intern Med . 2000;  160 761-768
    CrossrefPubMedGoogle Scholar
  • 111 Prandoni P, Lensing A WA, Cogo A. et al . The long-term clinical course of acute deep venous thrombosis.  Ann Intern Med . 1996;  125 1-7
    CrossrefPubMedGoogle Scholar
  • 112 Marzinotto V, Choi M, Massicotte M P, Chan A KC, Andrew M. Post-thrombotic syndrome in children with previous deep vein thrombosis (Abst).  Thromb Haemost . 2001;  78(Suppl) OC962
    PubMedGoogle Scholar
  • 113 Brandjes D PM, Büller H R, Heijboer H. et al . Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis.  Lancet . 1997;  349 759-762
    CrossrefPubMedGoogle Scholar
  • 114 Manco-Johnson M J, Nuss R, Hays T, Krupski W, Drose J. Combined thrombolytic and anticoagulant therapy for venous thrombosis in children.  J Pediatr . 2000;  136 446-453
    CrossrefPubMedGoogle Scholar
  • 115 Geerts W H, Jay R M, Code K I. et al . A comparison of low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma.  N Engl J Med . 1996;  335 701-707
    CrossrefPubMedGoogle Scholar
  • 116 Palmer A J, Koppenhagen K, Kirchhof B, Weber U, Bergemann R. Efficacy and safety of low molecular weight heparin, unfractionated heparin and warfarin for thrombo-embolism prophylaxis in orthopaedic surgery: a meta-analysis of randomised clinical trials.  Haemostasis . 1997;  27 75-84
    PubMedGoogle Scholar
  • 117 Seipelt R G, Franke A, Vazquez-Jimenez J F. et al . Thromboembolic complications after Fontan procedures: comparison of different therapeutic approaches.  Ann Thorac Surg . 2002;  74 556-562
    CrossrefPubMedGoogle Scholar
  • 118 van Ommen H C, Ottenkamp J, Lam J. et al . The risk of post-thrombotic syndrome in children with congenital heart disease.  J Pediatr . 2002;  141 582-586
    CrossrefPubMedGoogle Scholar
  • 119 Hirsh J, Warkentin T E, Shaughnessy S G. et al . Heparin and low-molecular-weight heparin: mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety.  Chest . 2001;  119 64S-94S
    CrossrefPubMedGoogle Scholar
  • 120 Andrew M, Marzinotto V, Brooker L A. et al . Oral anticoagulation therapy in pediatric patients: a prospective study.  Thromb Haemost . 1994;  71 265-269
    PubMedGoogle Scholar
  • 121 Streif W, Andrew M, Marzinotto V. et al . Analysis of warfarin therapy in pediatric patients: a prospective cohort study of 319 patients.  Blood . 1999;  94 3007-3014
    PubMedGoogle Scholar
  • 122 Hirsh J, Dalen J E, Anderson D R. et al . Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range.  Chest . 2001;  119 8S-21S
    CrossrefPubMedGoogle Scholar
  • 123 Marzinotto V, Monagle P, Chan A. et al . Capillary whole blood monitoring of oral anticoagulants in children in outpatient clinics and the home setting.  Pediatr Cardiol . 2000;  21 347-352
    CrossrefPubMedGoogle Scholar
  • 124 Massicotte P, Marzinotto V, Vegh P, Adams M, Andrew M. Home monitoring of warfarin therapy in children with a whole blood prothrombin time monitor.  J Pediatr . 1995;  127 389-394
    PubMedGoogle Scholar
  • 125 Beitzke A, Zobel G, Zenz W, Gamillscheg A, Stein J I. Catheter-directed thrombolysis with recombinant tissue plasminogen activator for acute pulmonary embolism after Fontan operation.  Pediatr Cardiol . 1996;  17 410-412
    CrossrefPubMedGoogle Scholar
  • 126 Knöfler R, Dinger J, Kabus M. et al . Thrombolytic therapy in children-clinical experiences with recombinant tissue-plasminogen activator.  Semin Thromb Hemost . 2001;  27 169-174
    Article in Thieme ConnectPubMedGoogle Scholar
  • 127 Kothari S S, Varma S, Wasir H S. Thrombolytic therapy in infants and children.  Am Heart J . 1994;  127 651-657
    CrossrefPubMedGoogle Scholar
  • 128 Rehan V K, Cronin C M, Bowman J M. Neonatal portal vein thrombosis successfully treated by regional streptokinase infusion.  Eur J Pediatr . 1994;  153 456-459
    CrossrefPubMedGoogle Scholar
  • 129 Nuss R, Hays T, Manco-Johnson M. Childhood thrombosis.  Pediatrics . 1995;  96 291-294
    PubMedGoogle Scholar
  • 130 Aschka I, Aumann V, Bergmann F. et al . Prevalence of factor V Leiden in children with thrombo-embolism.  Eur J Pediatr . 1996;  155 1009-1014
    CrossrefPubMedGoogle Scholar
  • 131 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;  128 324-328
    PubMedGoogle Scholar
  • 132 Nowak-Göttl U, Dubbers A, Kececioglu D. et al . Factor V Leiden, protein C, and lipoprotein(a) in catheter-related thrombosis in childhood: a prospective study.  J Pediatr . 1997;  131 608-612
    PubMedGoogle Scholar
  • 133 Uttenreuther-Fischer M M, Vetter B, Hellmann C. et al . Paediatric thrombo-embolism: the influence of non-genetic factors and the role of activated protein C resistance and protein C deficiency.  Eur J Pediatr . 1997;  156 277-281
    CrossrefPubMedGoogle Scholar
  • 134 Sifontes M T, Nuss R, Hunger S P, Waters J, Jacobson L J, Manco-Johnson M. Activated protein C resistance and the factor V Leiden mutation in children with thrombosis.  Am J Hematol . 1998;  57 29-32
    CrossrefPubMedGoogle Scholar
  • 135 Hagstrom J N, Walter J, Bluebond-Langner R, Amatniek J C, Manno C S, High K A. Prevalence of the factor V Leiden mutation in children and neonates with thromboembolic disease.  J Pediatr . 1998;  133 777-781
    PubMedGoogle Scholar
  • 136 Kohlhase B, Vielhaber H, Kehl H G, Kececioglu D, Koch H G, Nowak-Göttl U. Thromboembolism and resistance to activated protein C in children with underlying cardiac disease.  J Pediatr . 1996;  129 677-679
    PubMedGoogle Scholar
  • 137 Seixas C A, Hessel G, Siqueira L H, Machado T G S F, Gallizoni A M, Annichino-Bizzacchi J M. Study of hemostasis in pediatric patients with portal vein thrombosis.  Haematologica . 1998;  83 955-956
    PubMedGoogle Scholar
  • 138 Dubuisson C, Boyer-Neumann C, Wolf M, Meyer D, Bernard O. Protein C, protein S and antithrombin III in children with portal vein obstruction.  J Hepatol . 1997;  27 132-135
    CrossrefPubMedGoogle Scholar
  • 139 Fabri D, Belangero V MS, Annichino-Bizzacchi J M, Arruda V R. Inherited risk factors for thrombophilia in children with nephrotic syndrome.  Eur J Pediatr . 1998;  157 939-942
    CrossrefPubMedGoogle Scholar
  • 140 Nowak-Göttl U, Wermes C, Junker R. et al . Prospective evaluation of the thrombotic risk in children with acute lymphoblastic leukemia carrying the MTHFR TT 677 genotype, the prothrombin G20210A variant, and further prothrombotic risk factors.  Blood . 1999;  93 1595-1599
    PubMedGoogle Scholar
  • 141 Münchow N, Kosch A, Schobess R, Junker R, Auberger K, Nowak-Göttl U. Role of genetic prothrombotic risk factors in childhood caval vein thrombosis.  Eur J Pediatr . 1999;  158(suppl) S109-S112
    PubMedGoogle Scholar
  • 142 Wermes C, von Depka P, Lichtinghagen R, Barthels M, Welte K, Sykora K W. Clinical relevance of genetic risk factors for thrombosis in paediatric oncology patients with central venous catheters.  Eur J Pediatr . 1999;  158(Suppl) S143-S146
    CrossrefPubMedGoogle Scholar
  • 143 Knöfler R, Siegert E, Lauterbach I. et al . Clinical importance of prothrombotic risk factors in pediatric patients with malignancy-impact of central venous lines.  Eur J Pediatr . 1999;  158(Suppl) S147-S150
    CrossrefPubMedGoogle Scholar
  • 144 Heller C, Schobess R, Kurnik K. et al . Abdominal venous thrombosis in neonates and infants: role of prothrombotic risk factors-a multicentre case-control study. For the Childhood Thrombophilia Study Group.  Br J Haematol . 2000;  111 534-539
    CrossrefPubMedGoogle Scholar
  • 145 Mauz-Körholz C, Junker R, Gobel U, Nowak-Göttl U. Prothrombotic risk factors in children with acute lymphoblastic leukemia treated with delayed E. coli asparaginase (COALL-92 and 97 protocols).  Thromb Haemost. 2000;  83 840-843
    PubMedGoogle Scholar
  • 146 Atalay S, Akar N, Tutar H E, Yilmaz E. Factor V 1691 G-A mutation in children with intracardiac thrombosis: a prospective study.  Acta Paediatr . 2002;  91 168-171
    CrossrefPubMedGoogle Scholar
  • 147 Seixas C A, Hessel G, Ribeiro C C, Arruda V R, Annichino-Bizzacchi J M. Factor V Leiden is not common in children with portal vein thrombosis.  Thromb Haemost . 1997;  77 258-261
    PubMedGoogle Scholar
      >