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Mornand P, Chalard F, Romain AS, Rohr M, Paluel-Marmont C, Niakaté A, Quinet B, Grimprel E, Odièvre-Montanié MH. [Bilateral pulmonary embolism mimicking acute chest syndrome in an adolescent with sickle cell disease]. Arch Pediatr 2017; 24:625-629. [PMID: 28599856 DOI: 10.1016/j.arcped.2017.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 04/12/2017] [Indexed: 11/18/2022]
Abstract
Pulmonary embolism is a life-threatening and potentially lethal disease. Its incidence in children with sickle cell disease is probably underestimated and pediatric case reports in the literature are rare. Moreover, symptoms can mimic an acute chest syndrome. We report on the case of a 17-year-old boy with SS sickle cell disease, admitted for chest pain with dyspnea and tachycardia. Pulmonary angiography revealed a partial bilateral obstructive pulmonary embolism. We did not find any deep venous thrombosis or thrombophilia. The progression was rapidly favorable with anticoagulant therapy. We recommend a pulmonary angiography for any chest pain that does not evolve favorably in a child with sickle cell disease. Large series of pediatric patients would be useful to establish diagnostic and therapeutic guidelines.
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Affiliation(s)
- P Mornand
- Service de pédiatrie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.
| | - F Chalard
- Service de radiologie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
| | - A-S Romain
- Service de pédiatrie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
| | - M Rohr
- Service de pédiatrie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
| | - C Paluel-Marmont
- Service de pédiatrie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
| | - A Niakaté
- Service de pédiatrie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
| | - B Quinet
- Service de pédiatrie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
| | - E Grimprel
- Service de pédiatrie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France
| | - M-H Odièvre-Montanié
- Service de pédiatrie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France; UMR_S1134, institut national de la transfusion sanguine, 6, rue Alexandre-Cabanel, 75015 Paris, France
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Pulmonary thromboembolism in a child with sickle cell hemoglobin d disease in the setting of acute chest syndrome. Case Rep Pediatr 2013; 2013:875683. [PMID: 24159402 PMCID: PMC3789280 DOI: 10.1155/2013/875683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 08/24/2013] [Indexed: 11/24/2022] Open
Abstract
Introduction. Sickle cell hemoglobin D disease (HbSD) is a rare variant of sickle cell disease (SCD). Incidence of pulmonary thromboembolism (PE) and deep venous thrombosis (DVT) in children with HbSD is unknown. PE and DVT are known complications of SCD in adults but have not been reported in the literature in children with HbSD. Case Report. We are reporting a case of a 12-year-old boy with HbSD with acute chest syndrome (ACS) complicated by complete thrombosis of the branch of the right pulmonary artery and multiple small pulmonary artery emboli seen on computed tomography (CT) pulmonary angiogram and thrombosis of the right brachial vein seen on Doppler ultrasound. Our patient responded to treatment with anticoagulant therapy. Conclusion. There are no cases reported in children with HbSD disease presenting as ACS with pulmonary thromboembolism. We suggest that PE should be suspected in patients presenting with ACS who do not show improvement with standard management. CT pulmonary angiogram should be utilized for early diagnosis and appropriate management as there is no current protocol for management of PE/DVT in pediatric patients with SCD.
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Consenso sobre la clasificación de la enfermedad vascular pulmonar hipertensiva en niños: Reporte del task force pediátrico del Pulmonary Vascular Research Institute (PVRI) Panamá 2011. REVISTA COLOMBIANA DE CARDIOLOGÍA 2012. [DOI: 10.1016/s0120-5633(12)70157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Sickle cell disease and venous thromboembolism. Mediterr J Hematol Infect Dis 2011; 3:e2011024. [PMID: 21713075 PMCID: PMC3113276 DOI: 10.4084/mjhid.2011.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 05/14/2011] [Indexed: 01/21/2023] Open
Abstract
Hemoglobin S in homozygous state or in combination with one of the structural variants of Hb D-Punjab, Hb O-Arab, Hb C or β-thalassemia mutation results in sickle cell disease (SCD) that is characterized by chronic hemolytic anemia and tissue injury secondary to vasooclusion. A chronic hypercoagulable state in SCD has been established with the increased risk of thromboembolic complications in these patients. The goal of present review is to survey of the literature related to thromboembolic events and genetic risk factors involved in the manifestation of these events in SCD patients with focus on studies from Mediterranean countries. Also, this review covers the pathogenesis of hypercoagulability and alteration in the components of hemostasis system.
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Cerro MJD, Abman S, Diaz G, Freudenthal AH, Freudenthal F, Harikrishnan S, Haworth SG, Ivy D, Lopes AA, Raj JU, Sandoval J, Stenmark K, Adatia I. A consensus approach to the classification of pediatric pulmonary hypertensive vascular disease: Report from the PVRI Pediatric Taskforce, Panama 2011. Pulm Circ 2011; 1:286-298. [PMID: 21874158 PMCID: PMC3161725 DOI: 10.4103/2045-8932.83456] [Citation(s) in RCA: 166] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Current classifications of pulmonary hypertension have contributed a great deal to our understanding of pulmonary vascular disease, facilitated drug trials, and improved our understanding of congenital heart disease in adult survivors. However, these classifications are not applicable readily to pediatric disease. The classification system that we propose is based firmly in clinical practice. The specific aims of this new system are to improve diagnostic strategies, to promote appropriate clinical investigation, to improve our understanding of disease pathogenesis, physiology and epidemiology, and to guide the development of human disease models in laboratory and animal studies. It should be also an educational resource. We emphasize the concepts of perinatal maladaptation, maldevelopment and pulmonary hypoplasia as causative factors in pediatric pulmonary hypertension. We highlight the importance of genetic, chromosomal and multiple congenital malformation syndromes in the presentation of pediatric pulmonary hypertension. We divide pediatric pulmonary hypertensive vascular disease into 10 broad categories.
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