ABSTRACT

Iron deficiency anaemia is a common disorder in the paediatric age-group. The association between iron deficiency and venous thrombosis in children without an underlying illness is rare. Two cases are described. A 17-year-old girl had been taking oestrogen-progestogen therapy for contraception for about 2 years and developed a lower-limb deep vein thrombosis associated with pulmonary embolism. A 3-year-old girl was admitted to the paediatric emergency department with pallor, weakness and vomiting, and a cerebral CT showed a recent cerebral venous thrombosis. Both cases had severe iron-deficiency anaemia which increases a thrombotic tendency and could be a further crucial trigger of venous thrombosis in patients at low risk; therefore, in cases of unexplained thrombosis, it must always be considered to be a risk factor.

Abbreviations APCR: activated protein C resistance; CMV: cytomegalovirus; CT: computerised tomography; CVST: cerebral venous sinus thrombosis; CVT: cerebral venous thrombosis; DVT: deep vein thrombosis; DOACs: direct oral anticoagulants; EBV: Epstein–Barr virus; ID: iron deficiency; IDA: iron deficiency anaemia; LMWH: low molecular weight heparin; PE: pulmonary embolism; RDW: red blood cell distribution width; VT: venous thrombosis

摘要

缺铁性贫血是儿童年龄组的常见疾病。在没有潜在疾病的儿童中，缺铁与静脉血栓形成之间的关联很少见。描述了两种情况。一名 17 岁女孩已服用雌激素-孕激素避孕药约 2 年，并出现与肺栓塞相关的下肢深静脉血栓形成。一名 3 岁女孩因面色苍白、虚弱和呕吐被送入儿科急诊科，脑 CT 显示近期脑静脉血栓形成。两个病例都有严重的缺铁性贫血，这增加了血栓形成的趋势，并且可能是低风险患者静脉血栓形成的另一个关键触发因素；因此，在不明原因的血栓形成的情况下，必须始终将其视为危险因素。

缩写APCR：活化蛋白 C 抗性；CMV：巨细胞病毒；CT：计算机断层扫描；CVST：脑静脉窦血栓形成；CVT：脑静脉血栓形成；DVT：深静脉血栓形成；DOACs：直接口服抗凝剂；EBV：爱泼斯坦-巴尔病毒；ID：缺铁；IDA：缺铁性贫血；LMWH：低分子量肝素；PE：肺栓塞；RDW：红细胞分布宽度；VT：静脉血栓形成