A new diagnosis in children: The post-thrombotic syndrome

In childhood, the incidence of venous thrombosis is increasing, resulting in a growing number of children with complications of this disease, such as the post-thrombotic syndrome. Diagnosis of the post-thrombotic syndrome is based on the presence of typical symptoms and signs. Using standardized clinical criteria, pediatric studies show that the frequency of the post-thrombotic syndrome after symptomatic and asymptomatic venous thrombosis is 50 to 65%. Most post-thrombotic signs and symptoms are mild, including swelling, collateral veins and pain and/or heaviness in the affected extremity. Moderate post-thrombotic syndrome occurs in 10% of the pediatric patients after symptomatic venous thrombosis and includes swelling, collateral veins, telangiectases, malleolar flare, and pigmentation of the skin and complains of heaviness or pain in the affected leg while standing or walking. Potential risk factors for development of the post-thrombotic syndrome are recurrent, ipsilateral venous thrombosis, and the extent of the initial thrombus and clot lysis. The best method to prevent the syndrome is to prevent the initial thrombosis. The efficacy of compression stockings after venous thrombosis in preventing the post-thrombotic syndrome is unknown and needs to be evaluated in children.