Which factor predisposes certain children to intravascular thrombosis and possible pulmonary embolism?

• A. Sickle cell disease
• B. Asthma
• C. Allergies
• D. Gastroenteritis

Answer: (A)

Sickle cell disease creates a prothrombotic environment in children. When hemoglobin polymerizes and red blood cells sickle, they become rigid and stick to the endothelium, causing vaso-occlusion. This endothelial injury, plus ongoing hemolysis, activates platelets and the coagulation cascade and releases procoagulant microparticles. The result is an increased tendency for intravascular thrombosis, which can extend to the lungs and lead to pulmonary embolism, especially during dehydration, infection, or acute chest syndromes. Asthma and allergies mainly involve airway inflammation and do not drive this systemic hypercoagulable state, and gastroenteritis is an infection that can cause dehydration but doesn’t by itself create the same thrombotic risk. So the factor that predisposes to intravascular thrombosis and potential pulmonary embolism is sickle cell disease.