Case report of pulmonary embolism in pediatric practice

Abstract

An analysis of the clinical situation of a 14-year-old patient with pulmonary embolism (PE) and current information on the risk factors for the development of thrombotic events are presented. Due to the presence of gynecological pathology, the girl was prescribed hormonal drugs, in particular, dydrogesterone and estrogen + gestagen. Against the background of its use, complaints of shortness of breath appeared, which was regarded as a manifestation of bronchial obstruction and bronchodilator therapy was prescribed. Due to the lack of positive dynamics during treatment, she was hospitalized. MSCT of the chest organs was performed: signs of PE were revealed; A molecular genetic study of the DNA of buccal epithelial cells (PCR) was carried out: the carriage of prothrombogenic polymorphic variants of genes of the hemostasis system was revealed, the most significant of which is a heterozygous mutation of the prothrombin FII gene (G20210A); the study of the hemostasis system revealed thrombinemia. In therapy, thrombolysis was not performed, low molecular weight heparins were prescribed the child's condition improved. The question of the need for a comprehensive examination, including research on the carriage of prothrombogenic polymorphic variants of the genes of the hemostasis system for pediatric patients in situations requiring the administration of hormonal drugs for a long course, to prevent the ocurrence of dangerous thrombotic complications, is discussed.