Trombosis de la vena subclavia en una adolescente sin factores de riesgo

espanolLa trombosis venosa profunda es una entidad poco frecuente en pediatria. En los ultimos anos se ha observado un aumento de su incidencia, relacionado con una mayor utilizacion de cateteres centrales. Exponemos el caso de una nina previamente sana, sin factores de riesgo cardiovascular, que acude al servicio de urgencias por presentar enrojecimiento, edema, aumento de la trama vascular y sensacion de opresion en el brazo derecho de 3 semanas de evolucion. Se realizaron hemograma, bioquimica sanguinea y coagulacion basica, con resultados normales. La eco-Doppler puso de manifiesto una trombosis de la vena subclavia derecha. Se indico tratamiento ambulatorio, inicialmente con heparina de bajo peso molecular, y se mantuvo una pauta de anticoagulantes orales durante 6 meses. Una vez suspendido el tratamiento, se realizo un estudio de trombofilia, con resultados normales. Un ano despues, la nina se encuentra asintomatica y sin tratamiento. El manejo de este grupo de pacientes se realiza segun lo indicado en estudios sobre series de adultos, ya que los trabajos pediatricos publicados al respecto son escasos. EnglishDeep venous thrombosis is rarely seen in paediatrics. In recent years an increase has been noted in its incidence, linked to the greater use of central catheters. We report on the case of a previously healthy girl, free of cardiovascular risk factors, who came to the emergency services with reddening, oedema, increased vascular markings and a feeling of tightness in her right arm of 3 weeks of evolution. A haemogram, blood biochemistry analysis and basic coagulation tests were performed, with normal results. The echo-Doppler revealed a thrombosis of the right subclavian vein. An out-patient treatment was prescribed, initially with low-molecular-weight heparin, and a course of oral anticoagulants was maintained for 6 months. Once the treatment was stopped, a thrombophilia study was performed, with normal results. One year later, the girl is asymptomatic and without treatment. This group of patients is treated according to the findings of the studies on series of adults, since very few paediatric studies have been published on the subject