Yıl 2020, Cilt 3 , Sayı 1, Sayfalar 1 - 4 2020-02-26

Two years experience of a multidisciplinary approach for pediatric thrombosis in a tertiary referral center
Pediatrik tromboza multidisipliner yaklaşım, üçüncü basamak referans merkezin 2 yıllık deneyimi

Rumeysa TUNA [1] , Mustafa BİLİCİ [2] , Osman KİPOĞLU [3] , Orhan COŞKUN [4] , Zuhal BAYRAMOĞLU [5] , Suheyla OCAK [6] , Deniz TUĞCU [7] , Serap KARAMAN [8] , Ayşegül ÜNÜVAR [9] , Serra SENCER [10] , Nur AYDINLI [11] , Zerrin ÖNAL [12] , Zeynep YÜRÜK YILDIRIM [13] , Kemal NİŞLİ [14] , Rukiye EKER ÖMEROĞLU [15] , Aygün DİNDAR [16] , Zeynep İNCE [17] , Demet DEMİRKOL [18] , Mine ÇALIŞKAN [19] , Zeynep KARAKAŞ [20]


Pediatric thrombosis has unique characteristics due to its epidemiology, pathophysiology and treatment considerations. Children diagnosed with thrombosis should be evaluated by a multidisciplinary team at the level of diagnosis, treatment, and follow-up. Here we present our 2 years experience of pediatric thrombosis patients with a multidisciplinary thrombosis council management. We retrospectively reviewed case presentations and recommendations of monthly thrombosis council for 61 children (95 admissions) between November 2017 and August 2019. The male/female ratio was 1.54 and children and adolescents were the majority of evaluated 61 patients. Based on patients' clinical and radiological status, treatment and prophylaxis periods were determined. Cerebral arterial and sinovenous thrombosis were more common in our pediatric thrombosis council cases. Acquired risk factors for thrombosis were more common than congenital thrombophilia. Infection and elevated Factor VIII were commonest, respectively. Thirty-nine patients (64%) received primary or secondary prophylaxis with vitamin K antagonists, aspirin or LMVH for different periods. Further studies on treatment and prophylaxis management are needed for the improvement of evidence-based guidelines in pediatric thrombosis. Multidisciplinary councils may improve patient care for pediatric patients with complicated thrombosis. 

Pediatrik tromboz epidemiyolojisi, patofizyolojisi ve tedavi öncelikleri nedeniyle erişkin tromboz yönetiminden çok farklı özelliklere sahiptir. Tromboz teşhisi konan çocuklar, multidisipliner bir ekip tarafından tanı, tedavi ve takip süresince değerlendirilmelidir. Burada pediatrik tromboz hastalarımızın yönetildiği 2 yıllık multidisipliner tromboz konseyi deneyimimizi sunuyoruz. Kasım 2017-Ağustos 2019 tarihleri arasında 61 çocuk (95 başvuru) için tromboz konseyi olgu sunumlarını ve konsey sonuçlarını geriye dönük olarak inceledik. Değerlendirilen hastalarda erkek/kadın oranı 1,54 saptandı, çocuklar ve adolesanlar çoğunluktaydı. Hastaların klinik ve radyolojik durumlarına göre tedavi ve profilaksi süreleri belirlendi. Olgularımız içinde serebral arteriyel ve sinovenöz tromboz olguları daha fazla idi. Kazanılmış risk faktörleri, kalıtsal olanlardan daha fazla olup, infeksiyon ve Faktör VIII yüksekliği sık idi. Otuz dokuz hastaya (%64) farklı süreler boyunca K vitamini antagonistleri, aspirin veya LMVH ile primer veya sekonder profilaksi uygulandı. Pediatrik trombozda kanıta dayalı kılavuzların iyileştirilmesi için tedavi ve profilaksi yönetimi üzerine daha fazla çalışmaya ihtiyaç vardır. Multidisipliner tromboz konseyi komplike pediatrik trombozlu çocuk hastalarda hasta bakımını iyileştirebilir. 

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Konular Tıp
Bölüm Araştırma Makaleleri
Yazarlar

Orcid: 0000-0003-1821-3947
Yazar: Rumeysa TUNA (Sorumlu Yazar)
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Hematology-Oncology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-2393-1532
Yazar: Mustafa BİLİCİ
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Hematology-Oncology, Istanbul
Ülke: Turkey


Orcid: 0000-0001-9208-6697
Yazar: Osman KİPOĞLU
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Neurology, Istanbul
Ülke: Turkey


Yazar: Orhan COŞKUN
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Neurology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-1695-3290
Yazar: Zuhal BAYRAMOĞLU
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Radiology, Istanbul
Ülke: Turkey


Orcid: 0000-0001-7479-7444
Yazar: Suheyla OCAK
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Hematology-Oncology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-4374-7134
Yazar: Deniz TUĞCU
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Hematology-Oncology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-7428-3897
Yazar: Serap KARAMAN
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Hematology-Oncology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-4730-7697
Yazar: Ayşegül ÜNÜVAR
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Hematology-Oncology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-3942-093X
Yazar: Serra SENCER
Kurum: Istanbul University Faculty of Medicine, Department of Neuroradiology, Istanbul
Ülke: Turkey


Orcid: 0000-0003-0492-3411
Yazar: Nur AYDINLI
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Neurology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-7627-7423
Yazar: Zerrin ÖNAL
Kurum: İSTANBUL ÜNİVERSİTESİ
Ülke: Turkey


Orcid: 0000-0003-2891-2231
Yazar: Zeynep YÜRÜK YILDIRIM
Kurum: İSTANBUL ÜNİVERSİTESİ
Ülke: Turkey


Orcid: 0000-0001-9085-9852
Yazar: Kemal NİŞLİ
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Cardiology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-3740-6552
Yazar: Rukiye EKER ÖMEROĞLU
Kurum: İSTANBUL ÜNİVERSİTESİ, İSTANBUL TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0003-2801-6672
Yazar: Aygün DİNDAR
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Cardiology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-7304-099X
Yazar: Zeynep İNCE
Kurum: Istanbul University Faculty of Medicine, Department of Neonatology, Istanbul
Ülke: Turkey


Orcid: 0000-0001-9578-9267
Yazar: Demet DEMİRKOL
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Intensive Care, Istanbul
Ülke: Turkey


Orcid: 0000-0002-6869-3937
Yazar: Mine ÇALIŞKAN
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Neurology, Istanbul
Ülke: Turkey


Orcid: 0000-0002-8835-3235
Yazar: Zeynep KARAKAŞ
Kurum: Istanbul University Faculty of Medicine, Department of Pediatric Hematology-Oncology, Istanbul
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 26 Şubat 2020

APA TUNA, R , BİLİCİ, M , KİPOĞLU, O , COŞKUN, O , BAYRAMOĞLU, Z , OCAK, S , TUĞCU, D , KARAMAN, S , ÜNÜVAR, A , SENCER, S , AYDINLI, N , ÖNAL, Z , YÜRÜK YILDIRIM, Z , NİŞLİ, K , EKER ÖMEROĞLU, R , DİNDAR, A , İNCE, Z , DEMİRKOL, D , ÇALIŞKAN, M , KARAKAŞ, Z . (2020). Two years experience of a multidisciplinary approach for pediatric thrombosis in a tertiary referral center. Sağlık Bilimlerinde İleri Araştırmalar Dergisi , 3 (1) , 1-4 . Retrieved from https://dergipark.org.tr/tr/pub/sabiad/issue/52695/650905