Use of antiplatelet agents in pediatric hypercoagulable states
W. E. Hathaway
Many diseases in children are associated with thrombotic tendencies either
as a complication or as part of the pathophysiologic process. Disorders in
which platelet consumption and/or activation occur include
myeloproliferative syndromes, sickle cell disease, cardiac prostheses,
arteriovenous shunts, vasculitis, diabetes mellitus, and hemolytic-uremic
syndrome and other renal diseases. Platelet involvement can be demonstrated
by several indicators, including an increase in platelet release product
levels in the plasma (beta-thromboglobulin, platelet factor 4, and
thromboxane B2). The agents that have the greatest success in thrombotic
disorders where platelet involvement is prominent include the prostaglandin
pathway cyclo-oxygenase inhibitors aspirin and sulfinpyrazone, as well as
dipyridamole. Although indications and dosages for the use of antiplatelet
agents in children can be suggested, the treatment of each patient should
be individualized in light of current knowledge.
