Incidence of VTE in asymptomatic children with deficiencies of antithrombin, protein C, and protein S: a prospective cohort study.
Journal
Blood advances
ISSN: 2473-9537
Titre abrégé: Blood Adv
Pays: United States
ID NLM: 101698425
Informations de publication
Date de publication:
10 11 2020
10 11 2020
Historique:
received:
25
06
2020
accepted:
16
09
2020
entrez:
6
11
2020
pubmed:
7
11
2020
medline:
15
5
2021
Statut:
ppublish
Résumé
Although antithrombin, protein C, and protein S defects are well-recognized inherited risk factors for venous thromboembolism (VTE) in adults, whether they predispose children to these vascular disorders as well is undefined. In a prospective cohort study, we assessed the incidence of spontaneous and risk period-related VTE in children who were family members of adults who, after an episode of symptomatic VTE, had then been identified as carriers of these abnormalities. A total of 134 children from 87 families were enrolled. Seventy (51.5%) of these children were carriers of an inherited defect, and the remaining 64 were not; the mean observation period was 4 years (range, 1-16 years) and 3.9 years (range, 1-13), respectively. Sixteen risk periods were experienced by carriers, and 9 by noncarriers. Six VTE occurred in the 70 carriers during 287 observation-years, accounting for an annual incidence of 2.09% patient-years (95% confidence interval, 0.8-4.5), compared with none in the 64 noncarriers during 248 observation-years. Of the 14 children with thrombophilia who experienced a risk period for thrombosis, 4 (28.6%) developed a VTE episode. The overall incidence of risk-related VTE was 25% per risk period (95% confidence interval, 6.8-64). In conclusion, the thrombotic risk in otherwise healthy children with severe inherited thrombophilia does not seem to differ from that reported for adults with the same defects. Screening for thrombophilia in children who belong to families with these defects seems justified to identify those who may benefit from thromboprophylaxis during risk periods for thrombosis.
Identifiants
pubmed: 33156924
pii: S2473-9529(20)31940-6
doi: 10.1182/bloodadvances.2020002781
pmc: PMC7656938
doi:
Substances chimiques
Anticoagulants
0
Antithrombins
0
Protein C
0
Protein S
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5442-5448Informations de copyright
© 2020 by The American Society of Hematology.
Références
Stroke. 2000 Jun;31(6):1283-8
pubmed: 10835445
Front Pediatr. 2017 Mar 14;5:50
pubmed: 28352625
Circulation. 2010 Apr 27;121(16):1838-47
pubmed: 20385928
Blood. 1999 Dec 1;94(11):3702-6
pubmed: 10572082
Arch Dis Child Fetal Neonatal Ed. 1997 May;76(3):F163-7
pubmed: 9175945
Pediatrics. 1995 Nov;96(5 Pt 1):939-43
pubmed: 7478839
Blood. 2001 Feb 15;97(4):858-62
pubmed: 11159508
Thromb Haemost. 1999 Feb;81(2):198-202
pubmed: 10063991
Thromb Res. 2019 Sep;181 Suppl 1:S33-S36
pubmed: 31477225
Am J Dis Child. 1973 Dec;126(6):766-9
pubmed: 4759362
Chest. 1998 Nov;114(5 Suppl):748S-769S
pubmed: 9822076
Ann Intern Med. 1998 Jan 1;128(1):15-20
pubmed: 9424976
Blood. 2002 Mar 15;99(6):1938-42
pubmed: 11877263
Pediatr Res. 2000 Jun;47(6):763-6
pubmed: 10832734
Haematologica. 2019 Aug;104(8):1676-1681
pubmed: 30679327
Circulation. 2008 Sep 23;118(13):1373-82
pubmed: 18779442
J Pediatr. 2011 Oct;159(4):663-9
pubmed: 21596390
Arterioscler Thromb Vasc Biol. 1999 Oct;19(10):2568-72
pubmed: 10521389
J Pediatr. 1993 Sep;123(3):337-46
pubmed: 8355108
Blood. 1994 Mar 1;83(5):1251-7
pubmed: 8118029
Scand J Clin Lab Invest. 2018 Nov - Dec;78(7-8):551-555
pubmed: 30261760
N Engl J Med. 2001 Aug 9;345(6):417-23
pubmed: 11496852