|ELIZA WASILEWSKA, BARBARA KACZOROWSKA-HAĆ, MACIEJ NIEDŹWIEDZKI, MAŁGORZATA ZABOROWSKA-SOŁTYS, GRZEGORZ MINCEWICZ, ANNA BALCERSKA|
The authors present a case of 14-years old boy with purpura vera who developed cough and dyspnoea after 3 months of hydroxyurea therapy. His treatment for asthma bronchiale with nebulised ?-2 mimetic, steroide was unsuccessful. Chest HRCT scans, DLCO and spirometry results were normal. Perfusion scintigraphy showed extensive perfusion defects. High level of D-dimer (>2000 mg/ml) confirmed pulmonary embolism. Anticoagulant therapy with heparin and fibrinolytic agent (alteplase) was used with success. The patient was also shown to be deficient in protein S. The demonstrated case proves that pulmonary embolism should be considered during diagnosing as a discriminating factor in addition to such pathological respiratory symptoms as dyspnoea and cough, especially in patients with high-risk factors (hypercoagulable state, venous thrombosis, central venous catheters).
keywords: zatorowość płucna, zespół pseudoastmatyczny, niedobór białka S, dzieci, czerwienica prawdziwa, pulmonary embolism, pseudoasthmatic syndrome, protein S deficiency, children, purpura vera
pages: from 51 to 54
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