THROMBOTIC TENDENCY IN RENAL DISEASES IN PEDIATRICS

Abstract

Thrombotic tendency may be defmed as a state in which there is a risk of thrombosis in circumstances which would not usually cause thrombosis in the normal individual (Schafer et a/.,1994) Nephrotic syndrome i:; primarily a pediatric disorder and is 15 times more common in children than adults the incidence is 2-3 I 100.000 children per year and the vast majorily of affected children will have steroid - sensitive minimal change disease. The characteristic features of nephrotic syndrome are heavy proteinuria (>3.5 g I 24 hrs in adult, or 40 mg/m2/hr in children) ,Hypoalbuminemia (< 2.5 g/dl), oedema, and hyperlipidemia (Van de Walle eta/., 2001)

•Several haemostatic aberrations have a key role for the thromboembolic events associated with N.S.Thrombocytosis,platelet hyperaggregability, High plasma levels of clotting factors ,decreased fibrinolytic activity ,decreased level of AT III and plasminogen ,increased level of anti plasmin, increase level of antiplasmin and tissue plasminogen activator and increased mean plasma level of heparin cofactor II.

Modalities used to treat thrombotic complications include supportive care, anticoagulants and /or thrombolytic agents. (Andrew & Brooker, 1996)

Systemic lupus erthematosus (SLE) is a challenging 'autoimmune' • whose wide variety of manifestations makes it a necessary part of the differential diagnosis for children and adolescents with many different presenting complaints.