Prevalence of common thrombophilia markers and risk factors in Indian patients with primary venous thrombosis / Prevalência de marcadores comuns de trombofilia e fatores de risco em pacientes indianos com trombose venosa primária

CONTEXT AND OBJECTIVE: Venous thrombosis occurs as a result of interaction of genetic and acquired factors including activated protein C resistance (APC-R), fibrinogen levels, antithrombin, protein C, protein S, lupus anticoagulants and anticardiolipin antibodies. This study was aimed at determining the prevalence of these common thrombophilia markers in Asian Indians with primary venous thrombosis. DESIGN AND SETTING: This was a cross-sectional study carried out in Mumbai. METHODS: Samples from 78 patients with a confirmed diagnosis of venous thrombosis and 50 controls were tested. Semi-quantitative estimation (functional assays) of protein C, protein S and antithrombin was performed. Quantitative estimation of fibrinogen was done using the Clauss method. Lupus anticoagulants were screened using lupus-sensitive activated partial thromboplastin time and β2-glycoprotein-I dependent anticardiolipin antibodies were estimated by ELISA. APC-R was measured using a clotting-based method with factor V deficient plasma and Crotalus viridis venom. Statistical analysis was performed using Epi-info (version 6). RESULTS: The popliteal vein was the most commonly involved site. Forty-four samples (56 percent) gave abnormal results. The commonest were elevated fibrinogen and APC-R (17.9 percent each), followed by low protein S (16.6 percent). CONCLUSIONS: This study confirms the literature findings that fibrinogen level estimation and screening for APC-R are important for the work-up on venous thrombosis patients since these, singly or in combination, may lead to a primary thrombotic episode. The frequency of the other thrombophilia markers was higher among the patients than among the controls, but without statistically significant difference.

CONTEXTO E OBJETIVO: A trombose venosa ocorre como resultado da interação de fatores genéticos e adquiridos, incluindo resistência à proteína C ativada (APC-R), os níveis de fibrinogênio, antitrombina, proteína C, proteína S, anticoagulante lúpico e anticorpos anticardiolipina. Este estudo teve como objetivo verificar a prevalência de fatores trombofílicos frequentes em indianos com trombose venosa primária. TIPO DE ESTUDO E LOCAL: Estudo transversal analítico realizado em Mumbai. MÉTODOS: Foram testadas amostras de 78 pacientes com diagnóstico confirmado de trombose venosa e 50 controles. Foi realizada a dosagem sérica semiquantitativa (funcional) de proteína C, proteína S e antitrombina e a dosagem quantitativa de fibrinogênio (método de Clauss). Anticoagulantes lúpicos foram identificados por meio do tempo de tromboplastina parcial ativada sensível ao lúpus, e anticorpos anticardiolipina dependentes de β2-glycoproteína-I por ELISA. APC-R foi medida por método baseado em coagulação com plasma deficiente em fator V e veneno de Crotalus viridis. A análise estatística utilizou Epi-info (versão 6). RESULTADOS: A veia poplítea foi o local mais frequentemente afetado; 44 amostras (56 por cento) tiveram resultados anormais. Os achados mais frequentes foram elevação do fibrinogênio e APC-R (17,9 por cento cada), e baixa proteína S (16,6 por cento). CONCLUSÕES: Corroborando com a literatura, este estudo mostrou que a elevação do nível de fibrinogênio e a triagem para APC-R são importantes na avaliação de pacientes com trombose venosa, pois, individualmente ou em combinação, podem ter levado ao episódio trombótico primário. A frequência dos outros marcadores de trombofilia foi mais alta entre os doentes quando comparados aos controles, porém sem diferença estatisticamente significante.

Pseudoaneurisma de arteria poplitea como complicación de un osteocondroma femoral / Popliteal artery pseudoaneurysm complicating osteochondroma

Se presenta un caso de pseudoaneurisma de arteria poplítea, producido como complicación de un osteocondroma femoral. La arteria poplítea es la más frecuentemente afectada en éste tipo de complicaciones vasculares. En nuestro caso la combinación de ARM y RM permitió arribar a un diagnóstico de certeza evitando el empleo de métodos invasivos

Psoas Abscess Presenting with Femoropopliteal Vein Thrombosis

Psoas abscess is an uncommon condition with vague clinical presentation. It generally has an insidious onset and before the advent of computed tomography, few cases were reported in the medical literature. We report the case of a middle aged diabetic woman who presented with left leg swelling. Doppler ultrasound revealed thrombosis of the popliteal vein and a collection in the left groin. Computed tomography confirmed the presence of a large left iliopsoas abscess extending to the anterior compartment of the thigh complicated with thrombosis of the superficial femoral and popliteal veins. We suggest that an iliopsoas abscess should be excluded when an immunocompromised patient presents with deep vein thrombosis

Ruptura espontánea de la arteria epigástrica y trombosis venosa profunda: una asociación infrecuente / Spontaneous rupture of the epigastric artery and deep vein thrombosis

La ruptura "espontánea" de la arteria epigástrica constituye una afección vascular de baja incidencia con un diagnóstico que plantea dificultades en la mayoría de los casos. Los signos y síntomas son muy variados confundiéndose generalmente con procesos intraabdominales. Presentamos un caso cuyo hematoma originó una trombosis venosa profunda íleo femoral como forma de presentación. La misma no fue hallada en la bibliografía revisada y generó al inicio una incorrecta conducta terapéutica

Diagnosis of deep vein thrombosis in the leg by using colour coded duplex sonography

Deep Vein Thrombosis [DVT] is regarded rare in Asia. There is no documentation of the incidence of DVT in Pakistan. Clinical diagnosis of Deep Vein Thrombosis is inaccurate. Venography is the most reliable method of diagnosis, but it has several disadvantages. Many noninvasive diagnostic methods have therefore been developed in the past decade. Of these only duplex sonography has comparable accuracy. We studied 100 cases of suspected DVT by using, color coded duplex sonography. We report the results of a prospective study in patients with suspected deep vein thrombosis evaluated by both color coded Doppler sonography and venography. We conclude that color coded duplex sonography is a highly accurate, simple, non-invasive method for detecting femoropopliteal thrombosis. Additional venography is not necessary. Its value in diagnosing isolated calf vein thrombosis remains to be established

Tibial exostoses presenting with deep vein thrombosis

A rare case of tibial exostosis causing deep vein thrombosis is presented. The diagnosis was confirmed by ultrasonognaphy and venography Anticoagulants were given as treatment. The condition should be considered in any healthy young person presenting with lower limb pain. Surgical excision of the exostosis is recommended to avoid recurrence of the vascular problem