Evaluation and Management of Coagulopathies and Thrombophilias in Pediatric Patients

Abstract

The diagnosis of coagulopathy or thrombophilia in pediatric patients can be challenging. Congenital coagulopathies often present in the pediatric period and require appropriate work-up for diagnosis and ongoing management. Acquired coagulopathies of childhood are frequently encountered in hospitalized children and warrant appropriate coagulation testing for goal-directed therapy. The incidence of thrombosis is increasing in pediatric patients. After identifying the presence of thrombus, acute management includes initiating therapeutic anticoagulation. Choice of anticoagulant depends on patient's clinical status, along with availability of the anticoagulant. Thrombophilia evaluation is performed when children present with spontaneous thrombosis. Thrombophilia tests are inaccurate during acute illness.

Keywords: Acquired coagulopathy; Acquired thrombophilia; Anticoagulation; Congenital coagulopathy; Developmental hemostasis; Inherited thrombophilia; Routine coagulation testing; Venous thromboembolism.