Pulmonary embolism in childhood: how can we be sure not to miss it?

Biss, Tina

doi:10.1136/archdischild-2017-314428

Cited by 11 publications

(10 citation statements)

References 8 publications

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“…In pediatric patients with deep venous thrombosis (DVT) and pulmonary embolism (PE), antiphospholipid syndrome (APS) should be considered early and efforts must be made to ensure timely diagnosis of this potentially life-threatening condition. Pediatric APS is an autoimmune disease characterized by vascular thrombosis and persistently positive antiphospholipid antibodies [1,2,3,4,5]. Primary APS is rarely seen in childhood [4].…”

Section: To the Editormentioning

confidence: 99%

Pediatric Deep Venous Thrombosis and Pulmonary Embolism: Can It Be Antiphospholipid Syndrome?

Yenigürbüz¹,

Ören²

2019

Tjh

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Section: To the Editormentioning

confidence: 99%

Pediatric Deep Venous Thrombosis and Pulmonary Embolism: Can It Be Antiphospholipid Syndrome?

Yenigürbüz¹,

Ören²

2019

Tjh

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“…To the Editor, Pediatric chronic myeloid leukemia (CML) comprises 3% of childhood leukemia cases [1]. Similar to adults, most of the patients present in the chronic phase, but 5% may present in a blast crisis (BC) [2]. Mixed phenotypic BC has rarely been reported in children [3].…”

Section: To the Editormentioning

confidence: 99%

“…BC is usually myeloid and rarely mixed phenotypic [4]. The biology of progression of pediatric CML to BC is supposed to be similar to that of adults [2]. Accumulation of additional chromosomal anomalies in the proliferating clone, especially deletions in the CDKN2A/B gene, deletions in the IKZF gene, and chromosomal aberrations associated with myelodysplasia, have been implicated with progression [5].…”

Section: Pediatric Chronic Myeloid Leukemia Presenting In a Mixed Phementioning

confidence: 99%

Pediatric Deep Venous Thrombosis and Pulmonary Embolism: Can It Be Antiphospholipid Syndrome?

Yenigürbüz¹,

Ören²

2018

Tjh

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“…Pulmonary embolism (PE) occurs in only about 0.86 in 10 000 children in the general population each year but carries a high risk of mortality (~10%) . When PE is considered in a differential diagnosis, there is considerable decisional conflict because the clinical presentation of PE overlaps with many common pediatric diseases.…”

Section: Introductionmentioning

confidence: 99%

“…When PE is considered in a differential diagnosis, there is considerable decisional conflict because the clinical presentation of PE overlaps with many common pediatric diseases. The current criterion standard for PE diagnosis is computed tomography pulmonary angiogram (CTPA), but this carries the risk of radiation‐induced malignancy . Balancing the risk of missing a PE against the probable increased risk of a radiation‐induced malignancy presents a clinical conundrum for emergency medicine physicians caring for children.…”

Section: Introductionmentioning

confidence: 99%

Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children

Hennelly

Ellison

Neuman

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractBackground: Pulmonary embolism (PE) in children carries a significant morbidity and mortality. We examined previously described factors in 2 cohorts of children tested for PE and identified novel factors. Methods:We combined data from 2 retrospective cohorts. Patients up to age 21 years were included who underwent imaging or D-dimer testing for PE, with positive radiologic testing being the gold standard. Combined predictor variables were examined by univariate analysis and then forward stepwise multivariable logistic regression. Results: The combined data set yielded 1103 patients with 42 unique predictor variables, and 93 PE-positive patients (8.4%), with a median age of 16 years. Univariate analysis retained 17 variables, and multivariable logistic regression found 9 significant variables with increased probability of PE diagnosis: age-adjusted tachycardia, tachypnea, hypoxia, unilateral limb swelling, trauma/surgery requiring hospitalization in previous 4 weeks, prior thromboembolism, cancer, anemia, and leukocytosis. Conclusion: This combined data set of children with suspected PE discovered factors that may contribute to a diagnosis of PE: hypoxia, unilateral limb swelling, trauma/ surgery requiring hospitalization in previous 4 weeks, prior thromboembolism, and cancer, age-adjusted tachycardia, tachypnea, anemia, and leukocytosis. Prospective testing is needed to determine which criteria should be used to initiate diagnostic testing for PE in children. Essentials• Pulmonary embolism (PE) in children carries a significant morbidity and mortality.• We combined data from 2 retrospective cohorts and identified novel predictor variables.• Multivariable logistic regression found 9 significant variables associated with PE diagnosis.• Prospective testing is needed to determine which features predict pediatric PE diagnosis.

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Pulmonary embolism in childhood: how can we be sure not to miss it?

Cited by 11 publications

References 8 publications

Pediatric Deep Venous Thrombosis and Pulmonary Embolism: Can It Be Antiphospholipid Syndrome?

Pediatric Deep Venous Thrombosis and Pulmonary Embolism: Can It Be Antiphospholipid Syndrome?

Pediatric Deep Venous Thrombosis and Pulmonary Embolism: Can It Be Antiphospholipid Syndrome?

Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children

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