Pulmonary thromboembolism in children.

Pulmonary embolism in childhood is a rare but under-diagnosed condition. We report four children aged 5 to 13 years presenting with pulmonary emboli, their primary diagnoses being craniopharyngioma, asthma, Crohn's Disease and Reye's syndrome. The diagnosis was supported by technetium micro aggregate lung perfusion scans in three of the children and in the fourth, the only child to die, by autopsy. Three of the children had markedly elevated plasma osmolalities, one as a result of his diabetes insipidus and two following hyperosmolar treatment for cerebral oedema. The child who died was found to have a femoral vein thrombosis but the sites of origin of emboli in the other children were not defined.