Predictors of thrombotic complications in children with bleeding manifestations: 616.151.511-005.6-053.2-036

Abstract

Summary. Introduction. Children with inherited thrombophilia may have increased bleeding manifestations at certain periods of their childhood. The carriage of genetic polymorphisms that contribute to thrombophilia in relation to the occurrence of cerebrovascular event, heart attack, transient ischemic attack in adults has been well studied, but not fully analyzed in children with bleeding manifestations. Aim: to assess the prognostic significance of permanent and temporary thrombogenic risk factors in children with bleeding manifestations for prediction of thrombotic events in older age. Materials and Methods. A prospective, controlled, observational, comparative study of genetic polymorphisms of hemostasis system genes and genes of folate cycle enzymes was conducted in children with manifestations of hemorrhagic syndrome. Single nucleotide polymorphisms (SNP) were determined by a molecular genetic method using the polymerase chain reaction. Results. It was established that children with bleeding manifestations have a statistically significant prevalence of carriage of a rare homozygous genotype of the platelet receptor gene for collagen integrin subunit alpha 2 (ITGA2) and a rare homozygous genotype of the gene plasminogen activator inhibitor-1 (PAI-1). The study compiled the prognostic significance and informative value of certain constant and temporary signs to establish a prognostic scale for selecting children at risk of developing thrombotic complications in ontogenesis. Conclusion. Thus, the developed prognostic scale is characterized by a high specificity, as well as average sensitivity and prognostic significance of a positive result. When working with the proposed table, no more than 5% of erroneous decisions can be made. Using this scale,
children at risk of developing thrombotic complications were identified and included in the risk group with subsequent follow-up monitoring and primary prevention.

For citation: Strozenko L.A., Momot A.P., Tsyvkina L.P., Lobanov Yu.F., MomotD.A., PonomarevV.S. Predictors of thrombotic complications in children with bleeding manifestations. Tromboz, gemostaz i reologiya. 2025;(2):22–31. (In Russ.)

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