SAN DIEGO – Pediatric hematologists should consider testing for vitamin D deficiency to optimize bone health in children who will be receiving chronic anticoagulation. That’s a key message from a single-center retrospective review presented during a poster session at the biennial summit of the Thrombosis & Hemostasis Societies of North America.
“More research is needed to determine which children should be targeted for screening for low [bone mineral density], though our research suggests that children with prolonged treatment with steroids may be at the highest risk,” Kavita N. Patel, MD, one of the study’s authors, said in an interview.
While the use of chronic anticoagulation in adults has been shown to be associated with reduced bone mineral density (BMD), there is a paucity of research in children who are taking long-term anticoagulation and its effects on BMD, said Dr. Patel, of the department of pediatrics at Emory University, Atlanta.“A few studies have shown reduced BMD in children taking warfarin,” she said. “Subsequently, recommendations have been published that children receiving chronic anticoagulation undergo bone density testing. This study sought to determine if children who were receiving chronic anticoagulation [not only warfarin but also low molecular weight heparins and direct oral anticoagulants] had low BMD and whether the length of anticoagulation or any other medical conditions or medications affected the probability of having low BMD. We also wanted to report on the prevalence of low vitamin D in this same group of children since low vitamin D is a known risk for low BMD.”