Tromboembolismo pulmonar em criança com Distrofia Muscular de Duchenne: relato de caso

Abstract

OBJECTIVES: To describe a clinical case of pulmonary thromboembolism (PE) in a child with Duchenne muscular dystrophy. METHODS: A detailed description of the clinical picture and a review of the patients medical record were carried out, in addition to a discussion based on a literature review. DISCUSSION: PTE is not common in children and in 95% of cases it is secondary to an underlying cause or disease, with Duchennes disease being a predisposing condition due to the hypercoagulable state. Diagnosis in the pediatric population is not supported by tests validated as for adults; in this case, CT angiography was the exam of choice with sensitivity and specificity above 90%. In addition to diagnosis, a risk classification is essential, and supports the therapeutic choice. Therefore, low-risk patients receive anticoagulation, while high-risk patients receive thrombolytic therapy; in patients with contraindications to these drugs, surgical intervention may be necessary. Correct identification and early management are essential to delay disease progression and prevent sequelae, as well as avoid unnecessary invasive approaches. CONCLUSION: Due to the difficulty in diagnosing pulmonary thromboembolism in children, a detailed clinical investigation is essential, through the discussion of differential diagnoses and assessment of risk factors, since other diseases can mimic this clinical condition, which can present with signs and nonspecific symptoms.

Keywords

• pulmonary embolism
• muscular dystrophy
• duchenne
• child
• adolescent