Key result
Factor V Leiden and prothrombin gene G20210A mutations were not significantly associated with cerebral thromboembolism in children, including arterial ischemic stroke (OR 1.16; 95% CI 0.2-13.2).
Why the study?
Is there an association between factor V Leiden or prothrombin gene G20210A mutation and cerebral thromboembolism in children?
Case-Control (n=169)
No
Is there an association between factor V Leiden or prothrombin gene G20210A mutation and cerebral thromboembolism in children?
Odds Ratio: 1.16 (95% CI 0.2–13.2)
Absolute Event Rate: 2.3% vs 2%
p-value: p=0.99
Does not support routine thrombophilia screening in pediatric cerebral thromboembolism; leaves open need for larger multicenter confirmation.
We investigated whether there is an association between factor V Leiden (FVL) and/or prothrombin gene G20210A mutation (PT20210A) and cerebral thromboembolism in a pediatric Argentinean population. From May 1992 to January 2002, 44 consecutive children with arterial ischemic stroke (AIS) and 23 children with cerebral sinovenous thrombosis (SVT) were prospectively studied at a single center. The prevalence of both mutations was compared with a 102 age-matched controls. In children with AIS, the frequencies (patients vs. controls), odds ratio (OR), and 95% confidence interval (95% CI) for the presence of FVL were as follows: 2.3% vs. 2%, OR/95% CI, 1.16/0.2 to 13.2; P value = 0.99. No cases of PT20210A were found in this group. In children with SVT, the frequencies (patients vs. controls), OR, and 95% CI were as follows: FVL (4.3% vs. 2%, OR/95% CI, 2.27/0.22 to 6.2; P value = 0.99) and PT20210A (4.3% vs. 1%; OR/95% CI, 4.6/0.3 to 76.3; P value = 0.3354). One child with PT20210A also had an inherited protein C deficiency. In 12 (18%) out of the 67 children with cerebral thromboembolism, without the aforementioned mutations, other prothrombotic disorders were detected. Although a multi-center prospective study with a large number of Argentinean pediatric patients is needed to obtain considerable evidence, no association between factor V Leiden and/or prothrombin gene G20210A mutation and cerebral thromboembolism was found in this pediatric series.
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Bonduel et al. (2003) conducted a case-control in Cerebral thromboembolism (n=169). Factor V Leiden and/or prothrombin gene G20210A mutation vs. Age-matched controls was evaluated on Presence of Factor V Leiden in children with arterial ischemic stroke (OR 1.16, 95% CI 0.2 to 13.2, p=0.99). Factor V Leiden and prothrombin gene G20210A mutations were not significantly associated with cerebral thromboembolism in children, including arterial ischemic stroke (OR 1.16; 95% CI 0.2-13.2).
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