Reduced fibrinolysis linked to pediatric DVT risk
MedWire News: Hypofibrinolysis may play a key role in the development of noncatheter-related deep vein thrombosis (nCDVT) in children, study findings suggest.
Central venous catheters are the most common cause of pediatric DVT with the risk factors for and underlying causes of nCDVT events in children largely unknown.
The research, published in the journal Blood Coagulation and Fibrinolysis, examined fibrinolysis in 18 patients aged 2–20 years with nCDVT, and 18 age-, gender-, and race-matched children with no personal or family history of thrombosis.
There were no significant differences between the patients and controls with regard to platelet counts, plasminogen activator inhibitor (PAI)-1, fibrinogen, tissue plasminogen activator (tPA), or plasmin–antiplasmin complex.
However, levels of tissue activatable fibrinolysis inhibitor (TAFI) were significantly higher in patients versus controls, a phenomenon previously associated with thrombosis in adults, say Madhvi Rajpurkar (Wayne State University, Detroit, Michigan, USA) and co-authors.
Furthermore, whole-blood thromboelastography (TEG) showed that patients had significantly lower levels of fibrinolysis than controls, as indicated by reduced tPA lysis of a whole-blood clot at all measured time points.
“We…were able to demonstrate the usefulness and application of whole blood TEG in evaluating fibrinolysis in children,” Rajpurkar et al conclude.
They recommend that the role of TAFI and fibrinolysis in the development of pediatric nCDVT be examined further in larger studies.
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By Lynda Williams