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Continuing Medical Education (CME) Questions
Thrombophilia after perinatal stroke
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Curtis C, Mineyko A, Massicotte P, Leaker M, Jiang XY, Floer A, Kirton A. Thrombophilia risk is not
increased in children after perinatal stroke. Blood. 2017;129(20):2793-2800.
1. Your patient is a 2-year-old boy with a history of neonatal arterial ischemic stroke (NAIS) referred by his pediatrician for
evaluation of the etiology of his NAIS. According to the prospective, case-control study by Curtis and colleagues, which of the
following statements about rates of thrombophilias in children with perinatal stroke is correct?
M Quantified protein C and S and antithrombin levels were elevated in children with perinatal stroke vs control participants
M Factors VIII/IX/XI, fibrinogen, and lipoprotein(a) were elevated in children with perinatal stroke vs control participants
M Mean prothrombin time was not different in children with arterial strokes vs control participants
M Rates of antiphospholipid antibodies were low (7%), comparable to those of control participants, and resolved on subsequent
testing
2. According to the prospective, case-control study by Curtis and colleagues, which of the following statements about findings of
genotyping in children with perinatal stroke is correct?
M Rates of factor V Leiden (FVL) were significantly higher than population norms
M Rates of factor II G20210A were significantly higher than population norms
M For patients with the methylenetetrahydrofolate reductase C677T genotype, there were fewer arterial stroke patients carrying the
homozygous TT genotype vs the healthy population (9.1% vs 15%; P 5 .04)
M Prevalence of FVL heterozygosity varied significantly among stroke subgroups
3. According to the prospective, case-control study by Curtis and colleagues, which of the following statements about the clinical
implications of rates of thrombophilias in children with ischemic perinatal stroke is correct?
M Routine testing in childhood for thrombophilias is not indicated for these patients
M The study rules out the possibility of disordered coagulation at the time of stroke
M Testing for thrombophilia confers no risk of harm
M The study proves that maternal thrombophilias cause perinatal stroke in the offspring
DOI 10.1182/blood-2017-04-777433
2820
© 2017 by The American Society of Hematology
BLOOD, 18 MAY 2017 x VOLUME 129, NUMBER 20
From www.bloodjournal.org by guest on June 17, 2017. For personal use only.
2017 129: 2820
doi:10.1182/blood-2017-04-777433
Thrombophilia after perinatal stroke
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