Venous thromboembolism in two adolescents with Down syndrome

Abstract

Although venous thromboembolic events are relatively rare in children,they are an increasingly recognized clinical entity in pediatric tertiary carehospitals. Although vascular disorders are prevalent with Down syndrome,it remains unclear whether Down syndrome patients are at higher risk forvenous thromboembolic events. We report two adolescent cases with Downsyndrome who unexpectedly developed venous thromboembolism in a generalcare unit. Our cases had a few risk factors; laparoscopic radical surgery forHirschsprung's disease with central venous catheterisation in Case 1, andbacterial hepatic abscess in Case 2. Despite preventive heparinization withcatheterisation and minor surgery in Case 1 and non-sepsis in Case 2, bed restfor only a few days triggered sudden onset of deep vein thrombosis in lowerlimbs with pulmonary thromboembolism in both cases. We speculate that thecharacteristics of Down syndrome, including physical and behavioural problems,might cause venous thromboembolic events. Thus, we should pay moreattention to the relationship specifically between venous thromboembolismand Down syndrome, especially in adolescents, and increase prevention, earlydetection and treatment efforts.