THROMBOEMBOLIC DISEASES OF CHILDHOOD 3.57.51 PM

THROMBOEMBOLIC DISEASES OF CHILDHOOD 3.57.51 PM -...

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Unformatted text preview: THROMBOEMBOLIC DISEASES OF CHILDHOOD Dr. Tariq Roshan Need of the well designed prospective trials. Need of appropriate diagnostic strategies Confirmatory diagnostic test Need to establish standard drug regimens of different anti-thrombotic agents for Prevention treatment Out line for discussion Inherited thrombotic disorders Anti-thrombin deficiency Neonatal Purpura Fulminans (Homozygous Protein C & S deficiency) Activated protein C resistance Acquired thrombotic problems Non catheter related events Catheter related events Congenital thrombophilia Defined as having a positive family history Early age of onset of TE & Frequent recurrence It is suggested that the children with spontaneous TEs should be investigated History is important and carefully taken history will help in ordering investigations Clinically the most significant inherited prothrombotic disorders are AT PC PS APCR/FvL Prothrombin G20210 polymorphism Increased levels of factor VIII, IX, XI And recently Plasma lipoprotein (a) levels The occurrence of thrombosis in children of families with estiblished AT, PC, PS def. & FvL mutation was found to be low? Acquired risk factors were major contributors to the occurrence of TE The mean age at first TE was between 30 and 40 years but in females it is 20 years earlier than male in these families There is paucity of information on risk and benefits of long-term prophylaxis versus careful monitoring with intermittent prophylaxis Anti-thrombin deficiency Single chain GP, synthesized in the liver Serine protease inhibitor superfamily Direct inhibitor of thrombin Also inhibits Xa, IXa, XIa & XIIa Most important regulator of fibrin production Type I Quantitative Type II Functional II RS (reactive site defect) II HBS (heparin binding site defect) II PE (multiple site defect) Neonatal period and AT...
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THROMBOEMBOLIC DISEASES OF CHILDHOOD 3.57.51 PM -...

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