Hereditary thrombophilia as stroke aetiology in children: three case report Case Report

Abstract

Stroke a rare condition during childhood remains to be an important cause of mortality and morbidity The etiology of stroke in children is different from adults and could be determined only in the half of the cases previously However hereditary thrombophilias and coagulation defects have been more commonly identified during last two decades and the importance of the hereditary thrombophilias in the etiology of stroke is better understood Clarifying the etiology is important to predict the prognosis and prevent recurrences We report here three patients with hereditary thrombophilias leading stroke and discuss the importance as well as the treatment and prophylaxis of hereditary thrombophilias Turk Arch Ped 2007; 42: 165 9 Key words: Factor V leiden heparin hereditary thrombophilia nbsp; protein C protein S stroke

Keywords

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Çocuklarda inme etiolojisinde doğal inhibitör eksikliği: üç olgu sunumu Olgu Sunumu

Öz

Çocukluk çağında inme ender görülmekle birlikte önemli bir hastalık ve ölüm nedenidir Etiolojik nedenler erişkinlerden oldukça faklıdır Geçmiş yıllarda çocuklarda inmelerin yaklaşık yarısında etioloji saptanırken son nbsp; yıllarda doğal inhibitör eksikliklerinin tanınmasıyla kalıtsal trombofililerin inme etiolojisindeki yeri ve önemi daha iyi anlaşılmıştır Etiolojiyi bilmek seyir ve alevlenmeyi öngörmek açısından önem kazanmaktadır Bu yazıda doğal inhibitör eksikliği saptanan üç olgu nbsp; sunularak çocuklarda serebrovasküler hastalık etiolojisinde kalıtsal trombofililerin önemi tedavisi ve profilaksisi tartışıldı Türk Ped Arş 2007; 42: 165 9 Anahtar kelimeler: Faktör V leiden heparin inme kalıtsal trombofili protein C protein S

Anahtar Kelimeler

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Kaynakça

1. Kirkham FJ. Stroke and cerebrovascular disease in childhood. Current Paediatrics 2003;13: 350-9.
2. Schoenberg BS, Mellinger MD, Schoenberg DG. Cerebrovas- cular disease in infants and children: A study of incidence, cli- nical features and survival. Neurology 1978; 28: 763-8.
3. Menkes JH, Sarnat HB. Child Neurology. 6th ed. Philadelphia: Lippincott Williams, 2000: 893-5.
4. De Veber G, Andrew M, Adams C, et al. Cerebral sinovenous thrombosis in children. N Engl J Med 2001: 345; 417-23.
5. De Veber G. Canadian Pediatric Ischemic Stroke Registry. Can J Neurol Sci 1995; 22: 224.
6. Strater R, Becker S, Eckardstein A, et al. Prospective assess- ment of risk factors for recurrent stroke during childhood- a 5- year follow-up study. Lancet 2002; 360: 1540-5.
7. Baumer JH, Childhood arterial stroke. Guideline review. Arch Dis Child Educ Pract Ed 2004; 89: 50-3.
8. Akar N, Akar E, Yılmaz E, Factor V (his 1299 arg) in Turkish pa- tients with venous thromboembolism. Am J Hematol 2000; 63: 102-3.

9. Zoller B, Frutos PG, Hillarp A, Dahlback B. Thrombophilia as a multigenic disease. Haematologica 1999; 84: 59-70.
10. Kurnik K, Kosch A, Sträter R, et all. Recurrent thromboembo- lism in ınfants and children suffering from symptomatic ne- onatal arterial stroke. A prospective follow up study. Stroke 2003; 34: 2887-93.
11. Göttl NU, Junker R, Kreuz W, et al. Risk of recurrent venous thrombosis in children with combined prothrombotic risk fac- tors. Blood 2001; 97: 858-62.
12. Rosing J, Tans G. Factor V. Int J Biochem Cell Biol 1997; 29:1123-6.
13. Kirkham FJ, Prengler M, Hewes DK, Ganesan. Risk factors for arterial ischemic stroke in children. J Child Neurol 2000; 15: 299-307.
14. Rigby AC, Grant MA. Protein S: A conduit between anticoagu- lation and inflammation. Crit Care Med 2004; 32: 336-41.
15. Journeycake JM, Manco-Johnson MJ. Thrombosis during in- fancy and childhood. Haematol Oncol Clin N Am 2004; 18: 1315-38.
16. Barreirinho S, Ferro A, Santos M, et al. Inherited and acquired risk factors and their combined effects in pediatric stroke. Pediatr Neurol 2003; 28: 134-8.
17. Burak CR, Bowen MD, Baron TF. The use of enoxiparin in children with acute, nonhemorrhagic ischemic stroke. Pediatr Neurol 2003; 29: 295-8.