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Thrombophilia in children with cystic fibrosis.
Pediatr Pulmonol 2005; 39(4):306-10PP

Abstract

In some children with cystic fibrosis (CF), percutaneous long lines occlude sooner than expected (due to thrombophlebitis or thrombosis), and many have a totally implantable venous access device (TIVAD), a recognized complication of which is thrombosis. This complication is more likely if the child has an underlying thrombotic tendency, which may be enhanced in the presence of inflammatory lung disease. There are no reports of an identified association of heritable thrombophilia with CF, although individual cases have been recognized. Our aim was to determine the incidence of thrombophilia in children with CF. In a tertiary pediatric CF center, blood was screened for thrombophilia at annual review, and retested if abnormal. A thrombotic abnormality was found in 41/204 (20%) patients. These included activated protein C resistance (10/204, 5%) with a prevalence similar to that expected, but the following abnormalities had an increased prevalence: antithrombin deficiency (2/204, 1%), protein S deficiency (11/204, 5%), protein C deficiency (8/204, 4%), and lupus anticoagulant (18/204, 9%). There were no differences found in those with thrombophilia for the following parameters: age, gender, genotype, lung function, presence of Pseudomonas aeruginosa, prothrombin time, serum IgE, aspergillus-specific IgE, liver function, and blood inflammatory markers. Fifteen children had TIVADs, 4 of whom had evidence of thrombophilia. In conclusion, a significant proportion of patients had a thrombophilic abnormality. We recommend that thrombophilia screening be performed prior to insertion of a TIVAD, and also in those with a history of venous thrombosis, blocked TIVADs, or recurring problems with long lines.

Authors+Show Affiliations

Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15678507

Citation

Balfour-Lynn, I M., et al. "Thrombophilia in Children With Cystic Fibrosis." Pediatric Pulmonology, vol. 39, no. 4, 2005, pp. 306-10.
Balfour-Lynn IM, Malbon K, Burman JF, et al. Thrombophilia in children with cystic fibrosis. Pediatr Pulmonol. 2005;39(4):306-10.
Balfour-Lynn, I. M., Malbon, K., Burman, J. F., & Davidson, S. J. (2005). Thrombophilia in children with cystic fibrosis. Pediatric Pulmonology, 39(4), pp. 306-10.
Balfour-Lynn IM, et al. Thrombophilia in Children With Cystic Fibrosis. Pediatr Pulmonol. 2005;39(4):306-10. PubMed PMID: 15678507.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thrombophilia in children with cystic fibrosis. AU - Balfour-Lynn,I M, AU - Malbon,K, AU - Burman,J F, AU - Davidson,S J, PY - 2005/1/29/pubmed PY - 2005/9/2/medline PY - 2005/1/29/entrez SP - 306 EP - 10 JF - Pediatric pulmonology JO - Pediatr. Pulmonol. VL - 39 IS - 4 N2 - In some children with cystic fibrosis (CF), percutaneous long lines occlude sooner than expected (due to thrombophlebitis or thrombosis), and many have a totally implantable venous access device (TIVAD), a recognized complication of which is thrombosis. This complication is more likely if the child has an underlying thrombotic tendency, which may be enhanced in the presence of inflammatory lung disease. There are no reports of an identified association of heritable thrombophilia with CF, although individual cases have been recognized. Our aim was to determine the incidence of thrombophilia in children with CF. In a tertiary pediatric CF center, blood was screened for thrombophilia at annual review, and retested if abnormal. A thrombotic abnormality was found in 41/204 (20%) patients. These included activated protein C resistance (10/204, 5%) with a prevalence similar to that expected, but the following abnormalities had an increased prevalence: antithrombin deficiency (2/204, 1%), protein S deficiency (11/204, 5%), protein C deficiency (8/204, 4%), and lupus anticoagulant (18/204, 9%). There were no differences found in those with thrombophilia for the following parameters: age, gender, genotype, lung function, presence of Pseudomonas aeruginosa, prothrombin time, serum IgE, aspergillus-specific IgE, liver function, and blood inflammatory markers. Fifteen children had TIVADs, 4 of whom had evidence of thrombophilia. In conclusion, a significant proportion of patients had a thrombophilic abnormality. We recommend that thrombophilia screening be performed prior to insertion of a TIVAD, and also in those with a history of venous thrombosis, blocked TIVADs, or recurring problems with long lines. SN - 8755-6863 UR - https://www.unboundmedicine.com/medline/citation/15678507/Thrombophilia_in_children_with_cystic_fibrosis_ L2 - https://doi.org/10.1002/ppul.20181 DB - PRIME DP - Unbound Medicine ER -