Riten Kumar, Vilmarie Rodriguez, Clay Cohen, Madhvi Rajpurkar, Ayesha Zia
Boston Children’s Hospital and Harvard Medical School. Nationwide Children’s Hospital and Ohio State University. Texas Children’s Hospital and Baylor College of Medicine. Central Michigan University, Children’s Hospital of Michigan and Wayne State University. University of Texas Southwestern.
United States
Journal od Thrombosis and Hemostasis
J Thronb Hemost 2026;
DOI: 10.1016/j.jtha.2026.03.004
Abstract
Non-extremity thromboses constitute approximately 40% of pediatric venous thromboembolism and are associated with significant organ-specific morbidity. These events may lead to chronic complications such as post-pulmonary embolism syndrome after pulmonary embolism, neurocognitive impairment following cerebral sinus venous thrombosis, portal hypertension after portal vein thrombosis, and hypertension or chronic kidney disease following renal vein thrombosis. Despite their clinical relevance, the epidemiology, natural history, and optimal management of these sequelae remain incompletely defined in children, and existing recommendations, where available, rely largely on expert opinion or extrapolation from adult studies. Long-term follow-up practices are inconsistent, contributing to under recognition of chronic morbidity. In this JTH in Clinic review, we present four representative cases illustrating the spectrum of post-thrombotic sequelae arising from commonly encountered non-extremity thrombotic events in children. For each scenario, we summarize epidemiology, pathophysiology, and management considerations highlighting areas where pediatric-specific data are limited. This case-based approach aims to provide clinicians with our collective approach for recognizing, assessing, and managing long-term complications of non-extremity thrombosis. By emphasizing systematic surveillance and multidisciplinary follow-up, we aim to promote earlier identification and more consistent management of long-term sequelae in children with non-extremity VTE.
Category
Class IV. Pulmonary Hypertension Associated with Thromboembolic Disease
Class I. Pulmonary Hypertension Associated with Liver Disease
Pulmonary Arteriovenous Malformations
Review Articles Concerning Pulmonary Vascular Disea
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No