don’t dissolve when they should. A D-Dimer test can show if you have a condition that could be interfering with clotting. D-Dimer is normally undetectable or only detectable at very low levels unless your body is forming and breaking down significant blood clots. A positive or elevated D-dimer may indicate that your child has a clotting disorder, but it does not guarantee your child has one. Your child also may have testing to determine if the clot was caused by an inherited disorder. However, this testing is not done in all children who have a clot. ULTRASOUND Ultrasound is a technique that uses the echoes from high-frequency sound waves to produce a picture of internal organs or tumors. It has many uses, including finding tumors in the belly, checking the health of the kidneys and bladder, and measuring the size of some organs (like the liver, gall bladder, and spleen). A type of ultrasound that looks at the way blood flows and the condition of the blood vessels, venous Doppler ultrasound , can be used to diagnose clots in blood vessels. An ultrasound is a painless test that does not use radiation. The child lies on a table for a short time, and a clear jelly is smeared on the area being examined. (The jelly wipes off easily after the test.) A small round handle is moved around on the jelly to get a picture of the tissue or organ being examined. Depending on the location of the ultrasound, your child may not be allowed to eat or drink for several hours or may need to have a full bladder for the test. SCANS A scan is a way to look inside the body to see a clot. These types of scans may be used:
• CT (computed tomography) venograms are scans taken after a dye is injected into the blood. This shows the veins and how the blood flows through them. A venogram can help diagnose deep vein thrombosis (DVT), a serious type of blood clot. • An MRI (magnetic resonance imaging) venogram is a type of MRI that shows the blood vessels that carry blood back to the heart. This test is best for looking for a clot in the abdomen or brain. • A catheter dye study is a scan that shows pictures of the veins after a dye is injected into the blood through a tube. This scan is useful for looking at a leg or arm DVT or detecting a clot in or near a venous catheter. • A CT pulmonary angiogram is another type of CT scan taken after dye is injected into the blood. It can help find blood clots in the lungs. • A ventilation/perfusion (V/Q) scan measures blood and air flow through the lungs to help locate a clot in the lungs.
HOW IS THROMBOPHILIA TREATED? When a blood clot occurs, medicines called anticoagulants, or blood thinners, are used to stabilize the blood clot and prevent it from moving to other parts of the body. Anti means “against,” and coagulant refers to blood clotting. Your healthcare provider may prescribe anticoagulation medications to be taken at home. These anticoagulant medications can improve pain, reduce swelling, improve blood flow, and prevent further clot development. These medications do not dissolve clots; they stabilize a clot to keep it from moving to other parts of the body. Over time, the body can dissolve a clot or create new blood vessels for blood to travel through. Warfarin (Coumadin ®), enoxaparin (Lovenox®), and rivaroxaban (Xarelto®) are the three anticoagulant medications the U.S. Food and Drug Administration has approved for children.
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