{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:08:49Z","timestamp":1788858529341,"version":"build-2803163510"},"reference-count":22,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Paediatric pulmonary embolism (PE) is rare but potentially lethal, and its diagnosis is complicated by non-specific presentations and multiple predisposing risk factors. We describe a 15-year-old girl who presented with features of pulmonary hypertension and was found to have extensive pulmonary embolism with right heart strain. Methods: The diagnosis was established with echocardiography, computed tomography pulmonary angiography (CTPA), and Doppler ultrasonography. Results: Her predisposing risk factors comprised obesity (BMI 33 kg\/m2), a family history of thrombosis, and heterozygous Factor V Leiden. In retrospect, a six-week illness treated as bronchitis, with haemoptysis and exertional syncope, was the probable index embolic event; the markedly elevated right-sided pressures tolerated without haemodynamic collapse indicate a right ventricle that had adapted over that interval. Anticoagulation with low-molecular-weight heparin, titrated to anti-factor Xa activity, was followed by a vitamin K antagonist while antiphospholipid syndrome was excluded and then by rivaroxaban, with clinical, biochemical, and radiographic improvement. Conclusions: This report underscores the need for greater awareness of PE in children, the value of revisiting a recent respiratory illness as a possible index embolic event, and the evolving role of direct oral anticoagulants in its management.<\/jats:p>","DOI":"10.3390\/diagnostics16172842","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:21:21Z","timestamp":1788452481000},"page":"2842","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obese Adolescent with Factor V Leiden-Related Pulmonary Embolism: Case-Based Insight into Paediatric Thrombosis Management"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0229-4597","authenticated-orcid":false,"given":"Filip","family":"Bossowski","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Bia\u0142ystok, ul. Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0423-5734","authenticated-orcid":false,"given":"Magdalena","family":"Bossowska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Bia\u0142ystok, ul. Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Mas\u0142owska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Bia\u0142ystok, ul. Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"\u015aliwko","sequence":"additional","affiliation":[{"name":"Department of Paediatric Radiology, Medical University of Bia\u0142ystok, ul. Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"\u017b\u00f3rawska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Bia\u0142ystok, ul. Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kornel","family":"Semeran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Bia\u0142ystok, ul. Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek Robert","family":"Janica","sequence":"additional","affiliation":[{"name":"Department of Paediatric Radiology, Medical University of Bia\u0142ystok, ul. Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6316-5342","authenticated-orcid":false,"given":"Artur","family":"Bossowski","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Bia\u0142ystok, ul. Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jemermed.2011.03.006","article-title":"Pulmonary Embolism in Pediatrics","volume":"42","author":"Patocka","year":"2012","journal-title":"J. Emerg. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Branchford, B.R., Jaffray, J., and Mahajerin, A. (2018). Editorial: Pediatric Venous Thromboembolism. Front. Pediatr., 6.","DOI":"10.3389\/fped.2018.00269"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1111\/j.1365-2141.2008.07243.x","article-title":"Clinical Features and Outcome of Pulmonary Embolism in Children","volume":"142","author":"Biss","year":"2008","journal-title":"Br. J. 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