Clotting Disorders

Clotting disorders are also called thrombophilia. Having thrombophilia means that a child is more likely to get a blood clot. Blood clots are also known as thrombosis.

There are different types of blood clots:

Blood clots can cause Post-thrombotic syndrome.

A blood clot is a blockage in a child’s blood vessels. Blood vessels are divided into arteries and veins. Arteries carry blood full of oxygen and nutrients from a child’s heart to different parts or their body. Veins bring the blood with used up oxygen back to the heart and then to their lungs so that the blood can be re-oxygenated.

Blood clots in children are not common. For healthy children, only about 1 in 50,000-100,000 will get a blood clot. For teenagers, about 1 in 50,000 will get a blood clot and for young adults about 1 in 20,000 will get a blood clot.

In most cases, children who experience a blood clot are typically linked to a serious medical condition and/or a central line, a device that is inserted by a surgeon to provide direct access to the blood for giving medicines or drawing blood. Some names for central lines include Broviac or Hickman, Port or PICC line (peripherally inserted central catheter). However, there are times where blood clots occur in children who do not have a serious medical condition or a central line, but may be caused by an undiagnosed autoimmune disease, genetic conditions or birth control pills. Special blood tests are needed to test for genetic conditions.

The most common reasons, by age, for blood clots in children and young adults are:

Newborns

Central lines
Congenital heart disease
Rare and severe genetic blood clotting conditions

Infants and Toddlers

Central lines
Congenital heart disease
Serious infections of the blood, throat/neck, sinuses and bones
Cancer
Severe intestinal disorders

School Age Children

Central lines
Serious infections of the blood, throat/neck, sinuses and bones
Cancer
Autoimmune diseases
Severe intestinal disorders

Teenagers

Cancer
Central lines
Treatment with oral contraceptive pills
Serious infections of the blood, throat/neck, sinuses or bones
Autoimmune disorders

Young Adults

Treatment with oral contraceptive pills
Cancer
Autoimmune disorders
Serious infections of the blood, throat/neck, sinuses or bones

Blood Clots in Arteries

Pinky clot before treatment

Pinky clot after treatment

When a blood clot happens in an artery, a part of a child’s body will not get oxygen and nutrients. The most common forms of blood clots in arteries are heart attack (myocardial infarction) and stroke. Both of these conditions can cause death and are the most common cause of death in adults.

Children can get strokes and clots in their arteries, but overall this is very rare. The Children’s Hospital Los Angeles Hemostasis and Thrombosis Center cares for children who have suffered from a stroke or other arterial clots and provides ongoing care for patients to prevent any new strokes or clots. Schedule an appointment.

Blood Clots in Veins

Blood clots in veins are more common for children. Most children who get blood clots in veins have other medical conditions including cancer, heart disease and autoimmune diseases. Children with severe diseases of the stomach and intestine that require special nutrition treatment, total parenteral nutrition (TPN) that is injected into a person’s veins, are at greater risk for a blood clot. Patients with these conditions usually have a central line, which enhances their risk of a blood clot.

For patients who have had several central lines, having blood clots in more than one blood vessel can make it very hard to place a new central line if the current central line stops working or gets infected. The Hemostasis and Thrombosis Center has developed effective treatment approaches for children who need long-term central lines and have had blood clots or when doctors have told them that it will be impossible to place a new central line.

Pulmonary Embolism

Blood clots in veins are an uncommon, but serious medical problem, as clots can travel to the lungs causing a pulmonary embolism. A pulmonary embolism is when a blood clot clogs the main artery of the lung or one of its branches. Pulmonary embolism can be fatal among adults and children.

Post-Thrombotic Syndrome

Post Thrombotic Syndrome

Blood clots in the veins can also lead to post-thrombotic syndrome (PTS). Post-thrombotic syndrome happens when a vein is damaged by a blood clot so much that blood cannot flow back easily to the heart. This causes pain and swelling in the leg or arm where the clot was located. For a child that has had a blood clot in the neck and chest, PTS can lead to pain and swelling in the head. PTS is very hard to treat and the best way to manage PTS is to prevent it from occurring in the first place. This can be done by having the patient receive early and proper treatment for their blood clot.