Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review

Detalhes bibliográficos
Autor(a) principal: Andrade, Joana Verdelho
Data de Publicação: 2018
Outros Autores: Magalhães, Joana, Resende, Catarina, Gomes, Dora, Laranjo, Gabriela, Campos, Joana, Santos, Elisabete, Faria, Cristina
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639
Resumo: Introduction: Pulmonary thromboembolism and deep venous thrombosis occur in pediatric age, with unknown incidence, morbidity and mortality. Our aim is to review the epidemiology, clinical presentation, complementary diagnostic tests and prognosis of patients with pulmonary thromboembolism and deep venous thrombosis.Material and Methods: Retrospective, descriptive and analytical study of pediatric patients admitted to a Level II hospital for pulmonary thromboembolism and deep venous thrombosis, between 2000 and 2014. Demographic characteristics, clinical history, comorbidities and risk factors were studied.Results: Eleven patients (n = 7 pulmonary thromboembolism, n = 5 deep venous thrombosis, n = 1 both), 64% females and with 16 years old average, were admitted. All patients with pulmonary thromboembolism presented symptoms of chest pain and/or dyspnea, 25% syncope/palpitations and 25% fever. All patients with deep venous thrombosis reported localized pain at the site of obstruction, 83% edema/cyanosis of the affected limb and 17% fever. The study of positive thrombophilia was the most frequent risk factor in both entities. The mean value of D-dimers was 3252 ug/dL and 2660 ug/dL in pulmonary thromboembolism and deep venous thrombosis, respectively. All patients started anticoagulation, three required intensive care, two had sequelae and one died.Discussion: All patients had at least one risk factor, and hereditary hypercoagulability was most commonly established.Conclusions: The increased incidence in the pediatric population described in some studies can be attributed to an increased awareness of this pathology, medical advances and increasing survival of chronic diseases. There is a lack of evidence-based recommendations identifying patients at risk of thrombosis so that decisions can be made carefully, balancing the risk and benefit in each case.
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spelling Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective ReviewTromboembolismo Venoso em Idade Pediátrica: Estudo Retrospetivo de 15 AnosChildPulmonary EmbolismVenous ThrombosisCriançaEmbolia PulmonarTrombose VenosaIntroduction: Pulmonary thromboembolism and deep venous thrombosis occur in pediatric age, with unknown incidence, morbidity and mortality. Our aim is to review the epidemiology, clinical presentation, complementary diagnostic tests and prognosis of patients with pulmonary thromboembolism and deep venous thrombosis.Material and Methods: Retrospective, descriptive and analytical study of pediatric patients admitted to a Level II hospital for pulmonary thromboembolism and deep venous thrombosis, between 2000 and 2014. Demographic characteristics, clinical history, comorbidities and risk factors were studied.Results: Eleven patients (n = 7 pulmonary thromboembolism, n = 5 deep venous thrombosis, n = 1 both), 64% females and with 16 years old average, were admitted. All patients with pulmonary thromboembolism presented symptoms of chest pain and/or dyspnea, 25% syncope/palpitations and 25% fever. All patients with deep venous thrombosis reported localized pain at the site of obstruction, 83% edema/cyanosis of the affected limb and 17% fever. The study of positive thrombophilia was the most frequent risk factor in both entities. The mean value of D-dimers was 3252 ug/dL and 2660 ug/dL in pulmonary thromboembolism and deep venous thrombosis, respectively. All patients started anticoagulation, three required intensive care, two had sequelae and one died.Discussion: All patients had at least one risk factor, and hereditary hypercoagulability was most commonly established.Conclusions: The increased incidence in the pediatric population described in some studies can be attributed to an increased awareness of this pathology, medical advances and increasing survival of chronic diseases. There is a lack of evidence-based recommendations identifying patients at risk of thrombosis so that decisions can be made carefully, balancing the risk and benefit in each case.Introdução: O tromboembolismo pulmonar e trombose venosa profunda ocorrem em idade pediátrica com incidência, morbilidade e mortalidade desconhecidas. O objetivo foi rever epidemiologia, apresentação clínica, exames complementares de diagnóstico e prognóstico de doentes com tromboembolismo pulmonar e trombose venosa profunda.Material e Métodos: Estudo retrospetivo, descritivo e analítico de doentes pediátricos internados num hospital de nível II por tromboembolismo pulmonar e trombose venosa profunda, entre 2000 e 2014. Estudaram-se características demográficas, história clínica, comorbilidades e fatores de risco.Resultados: Foram internados 11 doentes (sete com tromboembolismo pulmonar, cinco com trombose venosa profunda e um com ambos), 64% do género feminino e idade média de 16 anos. Todos os doentes com tromboembolismo pulmonar referiam toracalgia/dispneia, 25% síncope/palpitações e 25% febre. Todos os doentes com trombose venosa profunda referiam dor no local da obstrução, 83% edema/cianose do membro afetado e 17% febre. O estudo da trombofilia positivo foi o fator de risco mais frequente nas duas entidades. O valor médio dos D-dímeros foi 3252 ug/L e 2660 ug/L no tromboembolismo pulmonar e trombose venosa profunda, respetivamente. Todos os doentes iniciaram anticoagulação, três necessitaram de cuidados intensivos, três apresentaram sequelas e houve um óbito.Discussão: Todos os doentes tinham pelo menos um fator de risco associado e as condições de hipercoagulabilidade herdadas foram o fator de risco mais frequentemente encontrado nos nossos adolescentes.Conclusão: O aumento da incidência na população pediátrica descrito na literatura pode ser atribuído à crescente sensibilização para esta patologia, aos avanços médicos e aumento da sobrevida de doenças crónicas. Escasseiam recomendações baseadas na evidência que identifiquem os doentes com risco de trombose, para que as decisões possam ser tomadas de forma cuidadosa, equilibrando o risco e benefício em cada caso.Ordem dos Médicos2018-09-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/mswordimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639oai:ojs.www.actamedicaportuguesa.com:article/9639Acta Médica Portuguesa; Vol. 31 No. 9 (2018): September; 489-495Acta Médica Portuguesa; Vol. 31 N.º 9 (2018): Setembro; 489-4951646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/5489https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/6053https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/10141https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/10365https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/10670Direitos de Autor (c) 2018 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessAndrade, Joana VerdelhoMagalhães, JoanaResende, CatarinaGomes, DoraLaranjo, GabrielaCampos, JoanaSantos, ElisabeteFaria, Cristina2022-12-20T11:05:47Zoai:ojs.www.actamedicaportuguesa.com:article/9639Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:44.012153Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review
Tromboembolismo Venoso em Idade Pediátrica: Estudo Retrospetivo de 15 Anos
title Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review
spellingShingle Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review
Andrade, Joana Verdelho
Child
Pulmonary Embolism
Venous Thrombosis
Criança
Embolia Pulmonar
Trombose Venosa
title_short Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review
title_full Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review
title_fullStr Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review
title_full_unstemmed Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review
title_sort Venous Thromboembolism in Pediatric Age: A 15 Year Retrospective Review
author Andrade, Joana Verdelho
author_facet Andrade, Joana Verdelho
Magalhães, Joana
Resende, Catarina
Gomes, Dora
Laranjo, Gabriela
Campos, Joana
Santos, Elisabete
Faria, Cristina
author_role author
author2 Magalhães, Joana
Resende, Catarina
Gomes, Dora
Laranjo, Gabriela
Campos, Joana
Santos, Elisabete
Faria, Cristina
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Andrade, Joana Verdelho
Magalhães, Joana
Resende, Catarina
Gomes, Dora
Laranjo, Gabriela
Campos, Joana
Santos, Elisabete
Faria, Cristina
dc.subject.por.fl_str_mv Child
Pulmonary Embolism
Venous Thrombosis
Criança
Embolia Pulmonar
Trombose Venosa
topic Child
Pulmonary Embolism
Venous Thrombosis
Criança
Embolia Pulmonar
Trombose Venosa
description Introduction: Pulmonary thromboembolism and deep venous thrombosis occur in pediatric age, with unknown incidence, morbidity and mortality. Our aim is to review the epidemiology, clinical presentation, complementary diagnostic tests and prognosis of patients with pulmonary thromboembolism and deep venous thrombosis.Material and Methods: Retrospective, descriptive and analytical study of pediatric patients admitted to a Level II hospital for pulmonary thromboembolism and deep venous thrombosis, between 2000 and 2014. Demographic characteristics, clinical history, comorbidities and risk factors were studied.Results: Eleven patients (n = 7 pulmonary thromboembolism, n = 5 deep venous thrombosis, n = 1 both), 64% females and with 16 years old average, were admitted. All patients with pulmonary thromboembolism presented symptoms of chest pain and/or dyspnea, 25% syncope/palpitations and 25% fever. All patients with deep venous thrombosis reported localized pain at the site of obstruction, 83% edema/cyanosis of the affected limb and 17% fever. The study of positive thrombophilia was the most frequent risk factor in both entities. The mean value of D-dimers was 3252 ug/dL and 2660 ug/dL in pulmonary thromboembolism and deep venous thrombosis, respectively. All patients started anticoagulation, three required intensive care, two had sequelae and one died.Discussion: All patients had at least one risk factor, and hereditary hypercoagulability was most commonly established.Conclusions: The increased incidence in the pediatric population described in some studies can be attributed to an increased awareness of this pathology, medical advances and increasing survival of chronic diseases. There is a lack of evidence-based recommendations identifying patients at risk of thrombosis so that decisions can be made carefully, balancing the risk and benefit in each case.
publishDate 2018
dc.date.none.fl_str_mv 2018-09-28
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/5489
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/6053
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/10141
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/10365
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9639/10670
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2018 Acta Médica Portuguesa
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 31 No. 9 (2018): September; 489-495
Acta Médica Portuguesa; Vol. 31 N.º 9 (2018): Setembro; 489-495
1646-0758
0870-399X
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