Background: The need for routine testing for thrombophilia in pediatric patients with migraine is unclear. The aims of this study were to evaluate the rate of thrombophilia and thrombotic risk factors in children and adolescents with migraine attending a pediatric headache clinic and to compare the findings with the healthy general same-age population.
Methods: The cohort included patients aged 3-18 years with migraine who underwent thrombophilia work-up at a pediatric headache clinic in 2013-2017. Background factors were analyzed by the thrombophilia test results and the indication for testing (clinic- or hematologist-derived). The prevalence of individual thrombotic factors was compared with a historical data of the general pediatric population.
Results: Of 824 patients diagnosed with migraine during the study period, 45 (5.5%) were screened for thrombophilia: 32 with aura, 13 without aura. At least one thrombotic factor was positive in 19 patients (42%). The rate of thrombophilia was higher in patients with aura than without aura. Lipoprotein A was the factor most often abnormal in the thrombophilia group among all the factors tested (8/19 patients, 42%), and it was the only factor with a significantly higher prevalence in the children with migraine than in the healthy historical controls.
Conclusion: Routine full thrombophilia testing in pediatric headache clinics does not seem to be justified. In this study, migraine with aura was associated with a higher thrombophilia rate than migraine without aura. Abnormally elevated lipoprotein levels were significantly more prevalent in children with migraine than in healthy children.
