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Thromboembolism

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Benign Hematologic Disorders in Children

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Abstract

Venous thromboembolism (VTE) is an increasing diagnosis among the pediatric population, primarily in hospitalized children. Pediatric VTE has a bimodal distribution with peaks in neonates and adolescents. The occurrence in pediatrics is commonly associated with at least one risk factor (personal, familial, anatomic, hospitalization, or other iatrogenic factor, underlying acute and/or chronic disease, or medication-associated). Diagnostic imaging is used for confirmation of the presence of thrombosis and includes ultrasound, computed tomography, and/or magnetic resonance imaging. Additional workup in pediatric VTE includes consideration of thrombophilia testing which is meant to identify additional contributing factors, consider changes or additions to therapy if indicated, and provide risk-prediction for future events. Thrombophilia testing includes assessment of natural anticoagulant protein deficiencies, genetic conditions, inflammatory markers, and other miscellaneous tests associated with increased risk of VTE. Best practices for pediatric thrombophilia testing remain elusive as non-genetic tests may be affected in the acute setting and comparison to age-specific reference ranges is not always available. The mainstay of treatment of pediatric VTE is anticoagulation with duration dependent on causation, response to treatment, presence of complications (namely bleeding), need for secondary prevention of recurrence, and patient/parent preference.

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Authors and Affiliations

  1. Seattle Children’s Hospital, Seattle, WA, USA

    Aimee Foord

  2. CHOC Children’s Hospital, Orange, CA, USA

    Arash Mahajerin

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  1. Aimee Foord
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  2. Arash Mahajerin
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Correspondence to Aimee Foord .

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  1. Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA

    Deepak M. Kamat

  2. Department of Pediatrics, Division of Hematology-Oncology, The University of Texas Health Science Center, San Antonio, TX, USA

    Melissa Frei-Jones

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Foord, A., Mahajerin, A. (2021). Thromboembolism. In: Kamat, D., Frei-Jones, M. (eds) Benign Hematologic Disorders in Children. Springer, Cham. https://doi.org/10.1007/978-3-030-49980-8_19

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  • DOI: https://doi.org/10.1007/978-3-030-49980-8_19

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