PEDIATRICS Vol. 116 No. 2 August 2005, pp. 447-453 (doi:10.1542/peds.2004-1905)
Prothrombotic Factors in Children With Stroke or Porencephaly
* Neuroepidemiology Branch
Family Studies Unit, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
Objective.This study compared the frequencies of genetic and functional coagulation abnormalities in children with arterial ischemic stroke or porencephaly with frequencies in previously published studies.
Methods.A series of 59 children (age 0–18 years) with arterial ischemic stroke or porencephaly were referred to the National Institutes of Health. A blood sample, buccal smear sample, questionnaire, and pedigree were requested for each child. Blood samples were analyzed for protein C (PC); protein S; antithrombin (AT); activated PC resistance (APCR); lipoprotein (a) [Lp(a)]; lupus anticoagulant; anticardiolipin antibodies; and the methylenetetrahydrofolate reductase C677T (MTHFR), factor V G1619A, factor II G20210A (PT), plasminogen activator inhibitor-1 4G6755G, and tissue factor pathway inhibitor C536T mutations. The frequency of each coagulation abnormality was compared with published international pediatric stroke case and control rates.
Results.At least 1 prothrombotic abnormality was identified in 63% (36 of 57) of children studied, including plasminogen activator inhibitor-1 4G6755G (15 of 56), MTHFR (12 of 56), elevated Lp(a) (12 of 59), APCR (11 of 58), factor V G1619A (5 of 57), PT (3 of 57), PC deficiency (1 of 59), and AT deficiency (1 of 59). The MTHFR mutation, elevated Lp(a), the PT mutation, and AT deficiency rates were similar to rates in cases and more common than control subjects in previously published studies. The rate of children with APCR or multiple abnormalities was higher than in previous pediatric stroke studies. A family history of early thrombosis was identified in one third of the children with a prothrombotic abnormality.
Conclusions.Two thirds of children in this study had at least 1 of the prothrombotic risk factors tested, and several children had multiple risk factors. These results provide additional evidence that prothrombotic abnormalities are common among children with AIS or porencephaly.
Key Words: cerebrovascular diseases • children • coagulation • genetic polymorphisms
Abbreviations: PC, protein C • PS, protein S • AT, antithrombin • FVL, factor V G1619A • PT, factor II G20210A • PAI-1, plasminogen activator inhibitor -1 4G6755G • MTHFR, methylenetetrahydrofolate reductase C677T • AIS, arterial ischemic stroke • APCR, activated protein C resistance • Lp(a), lipoprotein (a) • LA, lupus anticoagulant • ACLA, anticardiolipin antibodies • TFPI, tissue factor pathway inhibitor C536T • Ig, immunoglobulin
Accepted Nov 23, 2004.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  D. C. Herak, M. R. Antolic, J. L. Krleza, M. Pavic, S. Dodig, V. Duranovic, A. B. Brkic, and R. Zadro Inherited Prothrombotic Risk Factors in Children With Stroke, Transient Ischemic Attack, or Migraine Pediatrics, April 1, 2009; 123(4): e653 - e660. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Lo, J. Stephens, and S. Fernandez Pediatric Stroke in the United States and the Impact of Risk Factors J Child Neurol, February 1, 2009; 24(2): 194 - 203. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Laugesaar, A. Kolk, T. Tomberg, T. Metsvaht, M. Lintrop, H. Varendi, and T. Talvik Acutely and Retrospectively Diagnosed Perinatal Stroke: A Population-Based Study Stroke, August 1, 2007; 38(8): 2234 - 2240. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J.N.L. Benders, F. Groenendaal, C. S.P.M. Uiterwaal, P. G.J. Nikkels, H. W. Bruinse, R. A.J. Nievelstein, and L. S. de Vries Maternal and Infant Characteristics Associated With Perinatal Arterial Stroke in the Preterm Infant Stroke, June 1, 2007; 38(6): 1759 - 1765. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Skardoutsou, K. A. Voudris, S. Mastroyianni, E. Vagiakou, G. Magoufis, and P. Koukoutsakis Moya Moya Syndrome in a Child With Pyruvate Kinase Deficiency and Combined Prothrombotic Factors J Child Neurol, April 1, 2007; 22(4): 474 - 478. [Abstract] [PDF]
|
|
|
|
|
|
K. B. Nelson Perinatal Ischemic Stroke Stroke, February 1, 2007; 38(2): 742 - 745. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Miller, Y. W. Wu, J. Lee, E. J. Lammer, D. M. Iovannisci, D. V. Glidden, S. L. Bonifacio, A. Collins, G. M. Shaw, A. J. Barkovich, et al. Candidate Gene Polymorphisms Do Not Differ Between Newborns With Stroke and Normal Controls Stroke, November 1, 2006; 37(11): 2678 - 2683. [Abstract] [Full Text] [PDF]
|
|
