Fibrinolytic parameters in children with noncatheter thrombosis: a pilot study

Authors:
  • MCMeera B Chitlur
    Meera B Chitlur
  • WHWendy Hollon
    Wendy Hollon
  • OTOzgun Tosun
    Ozgun Tosun
  • RTRonald Thomas
    Ronald Thomas
  • IWIndira Warrier
    Indira Warrier
  • JLJeanne M Lusher
    Jeanne M Lusher
  • MRMadhvi Rajpurkar
    Madhvi Rajpurkar
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Abstract
Although the incidence of pediatric thrombosis has increased over the last decade, noncatheter-related deep venous thrombosis (nCDVT) is rare in children. Congenital and acquired hypercoagulable states may play an important role in the pathogenesis of nCDVT. In this study, we evaluated fibrinolytic parameters by measuring individual concentrations of fibrinolytic proteins and by tissue factor initiated whole blood thromboelastography (TEG), in which a fibrin clot was lyzed by exogenously added tissue plasminogen activator (tPA). Children with nCDVT were compared with age and sex-matched controls. TAFI concentrations were significantly higher in the patient group but there was no difference in the PAI-1, tPA and lipoprotein (a) concentrations. Significantly decreased fibrinolysis was found on TEG in the patient group suggesting that hypofibrinolysis may play an important role in the pathogenesis of nCDVT in children. To our knowledge, this is the first pediatric study that has systematically evaluated the role of fibrinolysis in the pathogenesis of DVT. Given our results, the role of fibrinolysis in the pathogenesis of nCDVT in children should be further evaluated in larger studies.

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