Pulmonary embolism in children, a real challenge for the pediatrician: a case report and review of the literature

Pulmonary embolism in children, a real challenge for the pediatrician: a case report and review of the literature

Authors

  • Alessandra Maggio
  • Lilia Altieri
  • Dario Pantaleo
  • Michela Grignani
  • Lidia Decembrino

Keywords:

adolescent, pulmonary embolism, thrombophilic genetic disorder, venous thromboembolism

Abstract

Venous thromboembolism (VTE) is a coagulopathic disease that may appear with deep vein thrombosis (DVT), pulmonary embolism (PE), or both and is responsible for increased mortality and morbidity in children. We report a case of PE in a male teenager obese boy in the setting of a thrombophilic genetic disorder, infective condition, and immobility. Our experience underlines as PE in childhood is a multifactorial disease in which clinical risk factors and inherited thrombophilia contribute to the development. It is crucial to identify one or more risk factors leading to the most appropriate diagnostic workup.

References

Stevenson GF, Stevenson FL. Pulmonary embolism in childhood. J Pediatr 1949;34:62‑9

Biss TT, Brandão LR, Kahr WH, et al. Clinical features and outcome of pulmonary embolism in children. Br J Haematol 2008;142:808–18.

Dijk FN, Curtin J, Lord D, et al. Pulmonary embolism in children. Paediatr Respir Rev 2012;13(2):112–22.

Jones RH, Sabiston DC. Pulmonary embolism in childhood. Monogr Surg Sci 1966;3(1):35–51.

Torbicki A, Perrier A, Konstantinides S, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: the task force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Heart J 2008;29(18):2276–315.

Agha BS, Sturm JJ, Simon HK, et al. Pulmonary embolism in the pediatric emergency department. Pediatrics. 2013; 132:663–7.

Biss TT. Pulmonary embolism in childhood: how can we be sure not to miss it? Arch Dis Child. 2018; 103:814–6.

Rajpurkar M, Biss TT, Amankwah EK, et al. Pulmonary embolism and in situ pulmonary artery thrombosis in paediatrics. A systematic review. Thromb Haemost 2017;117:1199–207

Andrew M, David M, Adams M, et al. Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE. Blood 1994; 83(5):1251–7.

Ishola T, Kirk SE, Guffey D, et al. Risk factors and comorbidities in adolescent thromboembolism are different than those in younger children. Thrombosis Research. 2016; 141:178–82.

Lee EY, Neuman MI, Lee NJ, et al. Pulmonary embolism detected by pulmonary MDCT angiography in older children and young adults: risk factor assessment. AJR 2012; 198:1431–1437

Raffini L, Huang Y-S, Witmer C, et al. Dramatic increase in venous thromboembolism in children’s hospitals in the United States from 2001 to 2007. Pediatrics 2009;124(4):1001–8.

Stein PD, Kayali F, Olson RE. Incidence of venous thromboembolism in infants and children: data from the National Hospital Discharge Survey. J Pediatr 2004;145(4):563–5.

Wang CY, Ignjatovic V, Francis P, et al. Risk factors and clinical features of acute pulmonary embolism in children from the community. Thromb Res 2016;138: 86–90.

Hancock HS, Wang M, Gist KM, et al. Cardiac findings and long-term thromboembolic outcomes following pulmonary embolism in children: a combined retrospective-prospective inception cohort study. Cardiol Young 2013;23(3): 344–52.

Fan EM, Gordner C, Luty J. Venous Thromboembolism in a Transgender Adolescent on Testosterone Therapy: A Case Report and Literature Review. J Pediatr Hematol Oncol 2020;42(5):e352-4.

Riedel M. Acute pulmonary embolism 1: pathophysiology, clinical presentation, and diagnosis. Heart. 2001;85:229–40

Emery JL. Pulmonary embolism in children. Arch Dis Child 1962;37(196):591–5

Van Ommen CH, Heyboer H, Groothoff JW, et al. Persistent tachypnea in children: keep pulmonary embolism in mind. J Pediatr Hematol Oncol 1998;20(6):570–3.

Young G, Albisetti M, Bonduel M, et al. Impact of inherited thrombophilia on venous thromboembolism in children: a systematic review and meta-analysis of observational studies. Circulation. 2008;118(13):1373-82.

Stokes S, Breheny P, Radulescu A, et al. Impact of obesity on the risk of venous thromboembolism in an inpatient pediatric population. Pediatr Hematol Oncol. 2014;31:475-80.

Halvorson EE, Ervin SE, Russell TB, et al. Association of obesity and pediatric venous thromboembolism. Hosp Pediatr. 2016;6:22–26

Sundbøll J, Angquist L, Kasper A, et al. Changes in Childhood Body-Mass Index and Risk of Venous Thromboembolism in Adulthood. J Am Heart Assoc. 2019;8(6):e011407.

Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 2006;354(22):2317–27.

Hennelly KE, Baskin MN, Monuteuax MC, et al. Detection of pulmonary embolism in high‐risk children. J Pediatr. 2016;178:214–8.

Rodger MA, Carrier M, Jones GN, et al. Diagnostic value of arterial blood gas measurement in suspected pulmonary embolism. Am J Respir Crit Care Med 2000;162:2105‑8.

Kanis J, Pike J, Hall CL, et al. Clinical characteristics of children evaluated for suspected pulmonary embolism with D‐dimer testing. Arch Dis Child. 2018;103:835–40.

Zaidi AU, Hutchins KK, Rajpurkar M. Pulmonary Embolism in Children. Front Pediatr. 2017;5:170.

Yang J, Paredes N, Chan AK. Antithrombotic therapy in children with venous thromboembolism. Hamostaseologie 2009;29:80‑7.

Monagle P, Barnes C, Ignjatovic V, et al. Developmental haemostasis: impact for clinical haemostasis laboratories. Thromb Haemost 2006;95:362-72.

Law C, Raffini L. A guide to the use of anticoagulant drugs in children. Paediatr Drugs. 2015;17:105–114.

Samuel ZG, Henri B. Pulmonary embolism and deep vein thrombosis. Lancet 2012;379:1835e46.

Kajy M, Blank N, Alraies C, et al. Treatment of a Child With Submassive Pulmonary Embolism Associated With Hereditary Spherocytosis Using Ultrasound-Assisted Catheter-Directed Thrombolysis. Ochsner J. 2019;19(3):264-70.

Pengo V, Lensing AWA, Prins MH, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004;350:2257–64.

Downloads

Published

06-06-2022

How to Cite

1.
Maggio A, Altieri L, Pantaleo D, Grignani M, Decembrino L. Pulmonary embolism in children, a real challenge for the pediatrician: a case report and review of the literature. Acta Biomed [Internet]. 2022 Jun. 6 [cited 2024 Jul. 18];93(S3):e2022055. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/13070