SPONTANEOUS DEEP VENOUS THROMBOSIS IN DUCHENNE MUSCULAR-DYSTROPHY

Deep venous thrombosis (DVT) is an uncommonly encountered condition in childhood and, as a consequence, the diagnosis may be overlooked. We describe the first two cases of DVT occurring in children with Duchenn e muscular dystrophy. Both brothers were wheelchair-bound for protract ed periods. The first case occurred following spinal fusion for scolio sis. The second occurred spontaneously following immobilisation in hos pital while undergoing investigation for a ureteric stone. Serological investigations to outrule an underlying thrombogenic cause showed no deficiency of protein C or antithrombin III nor the presence of lupus anticoagulant in either patient. The presence of flaccid lower extremi ties resulting in prolonged immobilisation combined with an ineffectiv e muscle pump for venous return may have predisposed the patients in o ur series. The issue of prophylaxis should now be actively considered in such patients in high-risk circumstances.