TY  - JOUR
TI  - Pulmonary Embolism in Childhood:  A Multicenter Experience from Turkey
AB  - Background: Pulmonary embolism is a clinical condition caused  by the obstruction of the pulmonary artery and its branches with  endogenous, exogenous embolism, or local thrombus formation. It is  a rare but potentially life-threatening event in the pediatric population.  Pediatric pulmonary embolism has many unknown characteristics.  Aims: To evaluate clinical features, genetic and acquired risk factors,  diagnostic imaging, and treatment strategies with long-term results in  children with pulmonary embolism. Study Design: A retrospective multicenter clinical trial Methods: Patients aged 0-18 years who were diagnosed with  pulmonary embolism with computed tomography pulmonary  angiography (CTPA) findings (intraluminal filling defect in the lobar  or main pulmonary artery) in 3 university hospitals between 2006  and 2021 were included in the study. A form was created for data  standardization, and variables were collected retrospectively through  medical record review. In addition to the features given above, we also  evaluated in situ pulmonary artery thrombosis (ISPAT) and patients’  Wells scores. Follow-up CTPA results were evaluated for patient  response to treatment. Complete recovery means that there were  no lesions, incomplete recovery if there was still embolism, and no  response if there was no change. Results: Twenty-four patients (female:13, male:11) were included in  the study. The mean age was 13.5 years. All patients but one had at  least one or more genetic or acquired risk factors. Factor V Leiden  mutation (16.6%) was the most common genetic risk factor. Six of  16 patients with Doppler ultrasonography were diagnosed with  ISPAT because there was no sign of thromboembolic thrombosis.  Nine (41.6%) patients had a Wells score of >4 (pulmonary embolism  clinically strong), and 15 (58.4%) patients scored <4 (pulmonary  embolism clinically likely weak), indicating that an alternative  diagnosis was more likely than pulmonary embolism (sensitivity  %37.5). The mean follow-up period was 23 (±17) months. Complete  and incomplete recovery was observed in 15 (62.5%) and 7 (29.1%)  patients, respectively, among the patients who underwent follow-up  evaluation. No response was obtained in 2 patients (8.3%) who died. Conclusion: The Wells scoring system seems insufficient to diagnose  pulmonary embolism in children and should be improved by adding  new parameters. ISPAT may be more common in children with  congenital heart disease and systemic disease.
AU  - kose, mehmet
AU  - Sismanlar Eyuboglu, Tugba
AU  - Tokgöz, Hüseyin
AU  - Tok, Tahir
AU  - KIRÇIL, NİHAN
AU  - Hangul, Melih
AU  - YILMAZ, Asli imran
AU  - Ramasli Gursoy, Tugba
AU  - PEKCAN, SEVGI
AU  - Aslan, Ayse Tana
AU  - ÇALISKAN, ÜMRAN
AU  - Ersoy, Ali
DO  - 10.4274/balkanmedj.galenos.2022.2022-3-46
PY  - 2022
JO  - Balkan Medical Journal
VL  - 39
IS  - 5
SN  - 2146-3123
SP  - 366
EP  - 373
DB  - TRDizin
UR  - http://search/yayin/detay/1132456
ER  -