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Blood Clots in Children

Posted on Mar 29, 2016

Blood clots are a serious and underdiagnosed problem, but can be prevented. During Deep Vein Thrombosis Month in March, Johns Hopkins All Children’s Hospital is raising awareness about blood clots by answering top questions on the minds of families.

How common are deep vein thromboses (DVT) and other blood clots in children?

Overall 1 in 10,000 children develop these problems. However, they are much more common in children who are hospitalized, with approximately 1 in 200 hospitalized children developing blood clots.

What are the common causes of blood clots in children?

  • Poor blood flow in the veins
  • Damage to the inner lining of veins; this can happen when a “central line” catheter, such as a “port” or “PICC,” is placed in a vein
  • Damage can also happen when certain drugs or toxins circulate in the blood
  • Inherited clotting conditions (also called genetic thrombophilia)
  • Illnesses and certain medications
  • Birth control pills, patches or rings that contain estrogen and other hormones increase the risk of blood clots for teenage girls
  • Reduced mobility, such as being confined to hospital bed or having paralysis in a limb from injury or stroke
  • Unusual structure or function of the blood vessels:
    • In May-Thurner syndrome, a vein in the left leg (iliac vein) narrows
    • In Paget-Schroetter syndrome, a vein where the arm meets the chest (subclavian vein) narrows

What are the signs and symptoms of blood clots in children?

Many of the signs and symptoms are the same in children and adults. If a patient has these signs or symptoms and a blood clot is suspected, imaging such as a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan or an ultrasound might be used to confirm a diagnosis, such as one of the following:

Deep vein thrombosis (DVT), a blood clot that forms in one of the deep veins in the body (such as in the leg or arm)

  • Painful swelling in an extremity

Cerebral sinovenous thrombosis, a blood clot that occurs in the veins that drain blood flow from the brain back to the heart

  • Unusually severe headache that may include blurred vision

Pulmonary embolism (PE), a blood clot that travels to a pulmonary artery

  • Chest pain that worsens with deep breathing
  • Cough with some blood in the sputum

What is the typical treatment for a blood clot in children?

Many times, physician will prescribe an anticoagulant medication – which works to treat and prevent the clotting of blood. Warfarin and heparin are often used to treat blood clots and can be used in children. Doses are typically adjusted and customized based on the child’s age and weight. However, warfarin is especially challenging to use in children because its anticoagulant effect is greatly influenced by diet and other medicines, requiring frequent blood draws.

What is Johns Hopkins All Children’s Hospital doing to help children with blood clots?

Johns Hopkins All Children’s Hospital is the coordinating center for the Kids-DOTT trial. It is a randomized, controlled and blinded study that will help physicians determine whether children with a venous thrombosis can safely and effectively receive only six weeks of treatment with anticoagulant medication instead of the current conventional treatment period of three months.

Kids-DOTT aims to answer questions about blood clots, and therefore has the potential to impact the future standard of care globally for children with venous thrombosis.

Learn more about Kids-DOTT



References:

Thrombosis and Thrombophilia in Children

Blood Clots in Children Resources
 


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