Pulmonary embolism and thrombosis in children

Yes, also kids can suffer from thrombosis. Even unborn children may develop a blood clot. As with adults, child thrombosis (blood clot) can form in the arteries or veins. 2/3 of these thromboses formed in veins. However, the risks of developing pulmonary embolism or deep vein thrombosis in children is much lower than in adults. While the risk of thrombosis or pulmonary embolism in adult is 1: 1000 per year, in children may be as low as 1: 1 million per year. Although this may be underestimated because in children this is rarely suspected.

In what situation does pulmonary embolism and thrombosis risk rise in children?

Most cases of deep vein thrombosis occur in children who have these risk factors:

  • Insertion of intravenous catheter (thin tube inserted into a vein) – the most common reason
  • Heart disease
  • Recent surgery
  • Recent injury
  • Cancer
  • Lupus
  • Rheumatoid arthritis
  • Diabetes
  • Kidney disease
  • Heart disease
  • Sickle cell anaemia
  • Leukaemia
  • Obesity
  • Thrombophilia

All these factors are also risk factors as well in adults. In general, children are less prone to the development of deep vein thrombosis and pulmonary embolism. More risk factors are usually in effect when thromboembolic disease in children develops. 80% of children who developed thrombosis or pulmonary embolism without other obvious risk factors are carriers of hereditary thrombophilia and usually combined forms of thrombophilia.

Diagnosis of thrombosis in children

Diagnosis of thromboembolism in children is not necessarily the same as in adults. As mentioned above, most cases of thrombosis in children are in connection with the placement of intravenous catheters. Intravenous catheters are typically placed in the arm or in a vein in the neck. These clots may be hardly seen by duplex ultrasound and magnetic resonance imaging may be required for diagnosis. For the diagnosis of pulmonary embolism is carried out ventilation perfusion scan.

Relatively little research on the treatment of thrombosis in children has been done yet. Specialists in Paediatric Haematology who treat children with deep vein thrombosis or pulmonary embolism tend to build their treatments based on data obtained from studies involving adults. Not only in children is still insufficient research, but also there is no liquid form of warfarin or child doses of LMWH in syringes. Because only few paediatricians have experience with treatment of children with blood clots, children with deep vein thrombosis or pulmonary embolism should be taken to the specialized clinic for the treatment of thrombosis and haemostasis. The good news is that children who were treated with warfarin for a long time, except for partial bone thinning, developed normally.

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