The clinical outcome after inferior vena cava thrombosis in early infancy
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The clinical outcome after inferior vena cava thrombosis in early infancy is unknown. We report the clinical long-term follow-up of 12 patients presenting inferior vena cava thrombosis within their first months of life (gestational age: 24–41 weeks; follow-up: 7±3 years). Accompanying renal venous thrombosis occurred in 9, and adrenal bleeding in 4 patients. A central venous catheter was related to the thrombosis in only four patients. Heterozygous factor V Leiden mutation was found in two of the eight infants without central venous catheter. Thrombolysis was performed in seven and effective in three infants; one infant required surgical thrombectomy. In three of eight infants with ineffective or with no therapy, spontaneous recanalization occurred during follow-up. No patient died of the thrombosis. Although no long-term anticoagulatory prophylaxis was performed, none of the children with persisting occlusion (n=5) or stenosis (n=1) of the inferior vena cava developed symptomatic thrombo-embolic complications. However, extensive internal collaterals (n=6), visible varicosis (n=5), pain in the legs (n=3) and persisting renal disease (n=3) with arterial hypertension (n=2) were observed during follow-up.
Conclusion Inferior vena cava thrombosis of early infancy frequently persists and may cause considerable long-term morbidity. New strategies for early and long-term therapy are necessary.
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- The clinical outcome after inferior vena cava thrombosis in early infancy
European Journal of Pediatrics
Volume 158, Issue 5 , pp 416-420
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- Key words Factor V deficiency
- Vena cava inferior
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- A1. Department of Paediatrics, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52057 Aachen, Germany, e-mail: Haeusler@RWTH-Aachen.de, Tel.: +49-241-8089738, Fax: +49-241-8888437, DE
- A2. Department of Clinical Radiology, University Hospital RWTH Aachen, Aachen, Germany, DE
- A3. Department of Paediatric Cardiology, University Hospital RWTH Aachen, Aachen, Germany, DE