Monika Grešíková
During the last decade much progress has been made toward better understanding of the underlying reasons causing venous thromboembolism in children. Compared to adult population, thromboembolism is uncommon in children, but when it occurs it can be devasting. Pediatric hematologists are frequently asked to evaluate children with symptomatic thrombosis or asymptomatic children, who have relatives affected with either thrombosis or thrombophilia. A considerable number of acquired and hereditary thrombotic risk factors have been identified which may also have an impact on therapeutic decisions and prognosis concerning outcome and the risk of a second event. The clinical utility of thrombophilia testing has become increasingly debated, both in adult and children. Children with thrombosis are a heterogenous group, and it is unlikely that a single approach to testing or treatment is optimal or desirable. However, indication for therapeutic interventions, such as thrombolysis and prophylactic anticoagulation with respect to the different clinical conditions and their combination with other risk factors, are not yet well defined. The following article describes the causes, clinical presentation, diagnostics and management of thrombosis in neonates, infants and older children, focusing on the clinically most relevant conditions.