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Early cerebral sinovenous thrombosis in a child with acute lymphoblastic leukemia carrying the prothrombin G20210A variant: a case report and review of the literature.

Abstract
This paper describes the case of a male child with acute lymphoblastic leukemia who developed cerebral sinovenous thrombosis on day 6 of induction therapy with intrathecal methotrexate and methylprednisolone. A central venous catheter had been implanted the day before. The heterozygous prothrombin G20210A variant was found together with acquired activated protein C resistance and a reduced activated partial thromboplastin time. Clinical course and magnetic resonance imaging with magnetic resonance venography gradually improved over the following days after starting anticoagulant therapy (heparin and nadroparin). Cerebral sinovenous thrombosis is a serious disease in leukemic children, occurring in up to 6% of these patients. Data from the literature are in favor of anti-coagulant treatment, even though the efficacy and safety of thromboprophylaxis during chemotherapy in leukemic children with inherited thrombophilic conditions remain to be demonstrated.
AuthorsStefano Mazzoleni, Maria C Putti, Paolo Simioni, Laura Sainati, Daniela Tormene, Renzo Manara, Modesto Carli
JournalBlood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis (Blood Coagul Fibrinolysis) Vol. 16 Issue 1 Pg. 43-9 (Jan 2005) ISSN: 0957-5235 [Print] England
PMID15650545 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Fibrinolytic Agents
  • Nadroparin
  • Prothrombin
Topics
  • Activated Protein C Resistance (diagnostic imaging, drug therapy, etiology)
  • Amino Acid Substitution (genetics)
  • Brain (diagnostic imaging)
  • Child, Preschool
  • Fibrinolytic Agents (administration & dosage)
  • Humans
  • Male
  • Nadroparin (administration & dosage)
  • Point Mutation
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications, diagnostic imaging, drug therapy)
  • Prothrombin (genetics)
  • Radiography
  • Sinus Thrombosis, Intracranial (diagnostic imaging, drug therapy, etiology)

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