Unexpected Multiple Organ Infarctions in a Poisoned Patient
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.
Abstract
Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.
참고문헌 (11)
- Lane DA, "Inherited thrombophilia:Part 1", Thromb Haemost, 76, pp.651~662 (1996)
- Bauer KA, "The thrombophilias: well-defined risk factors with uncertain therapeutic implications", Ann Intern Med, 135, pp.367~373 (2001)
- Clouse LH, "The regulation of hemostasis:the protein C system", N Engl J Med, 314, pp.1298~1304 (1996)
- Tait RC, "Prevalence of protein C deficiency in the healthy population", Thromb Haemost, 73, pp.87~93 (1995)
- Miletich J, "Absence of thrombosis in subjects with heterozygous protein C deficiency", N Engl J Med, 317, pp.991~996 (1987)
- van der Meer FJ, "The Leiden Thrombophilia Study (LETS)", Thromb Haemost, 78, pp.631~635 (1997)
- Tiong IY, "Protein C deficiency manifesting as an acute myocardial infarction and ischemic stroke", Heart, 89, pp.E7~ (2003)
- Kohler J, "Ischemic stroke due to protein C deficiency", Stroke, 21, pp.1077~1080 (1990)
- Magbool S, "Protein C deficiency presenting as pulmonary embolism and myocardial infarction in the same patient", Thromb J, 11, pp.19~ (2013)
- Mainwaring CJ, "Mesenteric infarction due to combined protein C deficiency and prothrombin 20210 defects", Postgrad Med J, 75, pp.742~743 (1999)
- D’Angelo A, "Acquired deficiencies of protein S. Protein S activity during oral anticoagulation, in liver disease, and in disseminated intravascular coagulation", J Clin Invest, 81, pp.1445~1454 (1988)