The clinical outcome after inferior vena cava thrombosis in early infancy

The clinical outcome after inferior vena cava thrombosis in early infancy i s unknown. We report the clinical long-term follow-up of 12 patients presen ting inferior vena cava thrombosis within their first months of life (gesta tional age: 24-41 weeks, follow-up: 7 +/- 3 years). Accompanying renal veno us thrombosis occurred in 9, and adrenal bleeding in 4 patients. A central venous catheter was related to the thrombosis in only four patients. Hetero zygous factor V Leiden mutation was found in two of the eight infants witho ut central venous catheter. Thrombolysis was performed in seven and effecti ve in three infants: one infant required surgical thrombectomy. In three of eight infants with ineffective or with no therapy, spontaneous recanalizat ion occurred during follow-up. No patient died of the thrombosis. Although no long-term anticoagulatory prophylaxis was performed, none of the childre n with persisting occlusion (n = 5) or stenosis (n = 1) of the inferior ven a cava developed symptomatic thrombo-embolic complications. However, extens ive internal collaterals (n = 6), visible varicosis (n = 5), pain in the le gs (n = 3) and persisting renal disease (n = 3) with arterial hypertension (IZ = 2) were observed during follow-up. Conclusion Inferior vena cava thrombosis of early infancy frequently persis ts and may cause considerable long-term morbidity. New strategies for early and long-term therapy are necessary.