Recommendations regarding thrombophilia testing in children.
| Who . | Recommendation . | Why . | Comments . |
|---|---|---|---|
| Adolescents with spontaneous thrombosis | Testing should be strongly considered | Identify combined defects Counsel regarding risk of recurrence Counsel/test other family members | This group has the highest prevalence of inherited thrombophilia |
| Neonates/children with non- catheter related venous thrombosis or stroke | Testing should be considered | Identify combined defects Counsel regarding risk of recurrence Counsel/test other family members | — |
| Neonates/children with symptomatic catheter- related thrombosis | Not enough data to make a recommendation | Reports vary regarding the role of thrombophilia in catheter-related thrombosis | — |
| Neonates/children with asymptomatic catheter- related thrombosis | Testing is not recommended | Thrombosis in the setting of catheter- related thrombosis is extremely common No data to suggest thrombophilia is increased | Consider testing if there are recurrent events |
| Asymptomatic children with a positive family history | Decision to test should be made on an individual basis only after counseling | Counsel adolescent females on risk of estrogen Thromboprophylaxis in high-risk situations | Be careful about false reassurance Test parent first, if possible Encourage waiting until child is older |
| Asymptomatic children- routine screening (prior to catheter placement, leukemia therapy or oral contraceptives) | Testing is not recommended | Not cost effective Many patients with risk factor will not have an event Catheter-related thrombosis not necessarily increased with inherited thrombophilia and there is no effective prophylaxis | — |
| Neonates/children participating in thrombosis research | Testing is recommended | More data on long term outcomes are needed to definitively determine the role of genetic risk factors and optimal therapies | — |
| Who . | Recommendation . | Why . | Comments . |
|---|---|---|---|
| Adolescents with spontaneous thrombosis | Testing should be strongly considered | Identify combined defects Counsel regarding risk of recurrence Counsel/test other family members | This group has the highest prevalence of inherited thrombophilia |
| Neonates/children with non- catheter related venous thrombosis or stroke | Testing should be considered | Identify combined defects Counsel regarding risk of recurrence Counsel/test other family members | — |
| Neonates/children with symptomatic catheter- related thrombosis | Not enough data to make a recommendation | Reports vary regarding the role of thrombophilia in catheter-related thrombosis | — |
| Neonates/children with asymptomatic catheter- related thrombosis | Testing is not recommended | Thrombosis in the setting of catheter- related thrombosis is extremely common No data to suggest thrombophilia is increased | Consider testing if there are recurrent events |
| Asymptomatic children with a positive family history | Decision to test should be made on an individual basis only after counseling | Counsel adolescent females on risk of estrogen Thromboprophylaxis in high-risk situations | Be careful about false reassurance Test parent first, if possible Encourage waiting until child is older |
| Asymptomatic children- routine screening (prior to catheter placement, leukemia therapy or oral contraceptives) | Testing is not recommended | Not cost effective Many patients with risk factor will not have an event Catheter-related thrombosis not necessarily increased with inherited thrombophilia and there is no effective prophylaxis | — |
| Neonates/children participating in thrombosis research | Testing is recommended | More data on long term outcomes are needed to definitively determine the role of genetic risk factors and optimal therapies | — |