Abstract 28
Data from 88 children with 92 thrombotic episodes at various sites were analyzed. Extensive thrombosis was observed in 11.4% of cases, thrombosis at multiple sites in 10.2% and recurrent thrombosis in 9.1%. CNS was the most commonly affected site (46.9%), DVT of upper or lower extremities represented 17.3% of cases, arterial thrombosis was evidenced in 26.5% of cases. Underlying disease was documented in 63.6% of cases and triggering event (s) in 40.2%. Of the tested children for conditions predisposing to thrombosis (↓ATIII, ↓PC, ↓PS, ↓Plg, APCR, mutant FV, mutant FII, dysfibrinogenaemia, ↑Fribinogen, ↑FII, ↑VII, ↑VIII, ↓XII, LA, ACA, homocysteimaemia), 53.4% showed one or more abnormal results which in most cases were acquired and only in 11.4% of cases were congenital (mutant FV: 4, mutant FII: 2 cases, APCR: 3, homocystinuria: 1). In almost half the thrombotic episodes more than one imaging techniques were applied for documentation of thrombosis. 58.7% of the thrombotic episodes were treated with rtPA or/and heparin usually followed by warfarin. Thrombus was removed in two cases (aortic arch thrombosis, pulmonary embolism). CNS infarcts, and CNS arterial thrombosis were managed conservatively in all but three cases. However six out of 11 children with sinus thrombosis were effectively treated with rtPA or/and heparin. Complete resolution was documented radiographically in 35/57 cases, partial resolution in 11 and no change in another eleven cases. The mortality rate was 8% (7/88). Four children died as a result of thrombosis. The clinical outcome was good in 57% of 58 children recently re-evaluated, whereas 39.7% of children presented with a neurological deficit, mostly due to untreated CNS insults.
