Thrombophilia and first arterial ischaemic stroke: a systematic review

被引:88
作者
Haywood, S
Liesner, R
Pindora, S
Ganesan, V
机构
[1] UCL, Inst Child Hlth, Wolfson Ctr, Neurosci Unit, London WC1N 2AP, England
[2] UCL, Inst Child Hlth, Paediat Epidemiol & Biostat Unit, London WC1N 2AP, England
[3] Great Ormond St Hosp Sick Children, Dept Haematol, London WC1N 3JH, England
关键词
D O I
10.1136/adc.2004.049163
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Aims: To undertake a systematic review of the literature reporting the prevalence of thrombophilia in children with a first arterial ischaemic stroke (AIS). Methods: Systematic review of case-control studies reporting data for prevalence of protein C, S, and antithrombin ( AT) deficiencies, activated protein C resistance (APCr), total plasma homocysteine >95th centile, the thrombophilic mutations factor V1691 GA, prothrombin 20210GA, and MTHFR C677T in children with first, radiologically confirmed, AIS. Results: Of 1437 potentially relevant citations, 18 met inclusion criteria. A total of 3235 patients and 9019 controls had been studied. Results of meta-analyses were expressed as pooled odds ratios ( OR) relating the prevalence of the thrombophilic condition in children with AIS to that in controls. The pooled OR ( and 95% CI) were: protein C deficiency, 6.49 (2.96 to 14.27); protein S deficiency, 1.14 (0.34 to 3.80); AT deficiency, 1.02 (0.28 to 3.67); APCr, 1.34 (0.16 to 11.52); FV1691 GA, 1.22 (0.80 to 1.87); PT20210GA, 1.10 (0.51 to 2.34); MTHFR C677T, 1.70 (1.23 to 2.34); and total plasma homocysteine >95th centile, 1.36 (0.53 to 3.51). There was no statistical heterogeneity within these data. Conclusions: All factors examined were more common in children with first AIS than in controls, and significantly so for protein C deficiency and the MTHFR C677T mutation. The implications of thrombophilia for prognosis and recurrence need to be established before clinical recommendations can be made regarding investigation and treatment of children with AIS.
引用
收藏
页码:402 / 405
页数:4
相关论文
共 28 条
  • [1] Common mutations at the homocysteine metabolism pathway and pediatric stroke[J]. Akar, N;Akar, E;Özel, D;Deda, G;Sipahi, T. THROMBOSIS RESEARCH, 2001(02)
  • [2] ALTMAN D, 2001, SYSTEMATIC REV HEALT
  • [3] VENOUS THROMBOEMBOLIC COMPLICATIONS (VTE) IN CHILDREN - FIRST ANALYSES OF THE CANADIAN REGISTRY OF VTE[J]. ANDREW, M;DAVID, M;ADAMS, M;ALI, K;ANDERSON, R;BARNARD, D;BERNSTEIN, M;BRISSON, L;CAIRNEY, B;DESAI, D;GRANT, R;ISRAELS, S;JARDINE, L;LUKE, B;MASSICOTTE, P;SILVA, M. BLOOD, 1994(05)
  • [4] ANESAN V, 1999, THESIS U LONDON
  • [5] STROKE IN CHILDREN WITHIN A MAJOR METROPOLITAN-AREA - THE SURPRISING IMPORTANCE OF INTRACEREBRAL HEMORRHAGE[J]. BRODERICK, J;TALBOT, GT;PRENGER, E;LEACH, A;BROTT, T. JOURNAL OF CHILD NEUROLOGY, 1993(03)
  • [6] Cardo E, 1999, Eur J Paediatr Neurol, V3, P113, DOI 10.1016/S1090-3798(99)90098-3
  • [7] Children with stroke:: Polymorphism of the MTHFR gene, mild hyperhomocysteinemia, and vitamin status[J]. Cardo, E;Monrós, E;Colomé, C;Artuch, R;Campistol, J;Pineda, M;Vilaseca, MA. JOURNAL OF CHILD NEUROLOGY, 2000(05)
  • [8] Prothrombotic disorders in infants and children with cerebral thromboembolism[J]. deVeber, G;Monagle, P;Chan, A;MacGregor, D;Curtis, R;Lee, S;Vegh, P;Adams, M;Marzinotto, V;Leaker, M;Massicotte, P;Lillicrap, D;Andrew, M. ARCHIVES OF NEUROLOGY, 1998(12)
  • [9] Inherited prothrombotic states and ischaemic stroke in childhood[J]. Ganesan, V;McShane, MA;Liesner, R;Cookson, J;Hann, I;Kirkham, FJ. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1998(04)
  • [10] Prothrombotic risk factors in childhood stroke and venous thrombosis[J]. Heller, C;Becker, S;Scharrer, I;Kreuz, W. EUROPEAN JOURNAL OF PEDIATRICS, 1999(Suppl 3)