Can monocytosis act as an independent variable for predicting deep vein thrombosis?

INTRODUCTION: Deep venous thrombosis (DVT) is a manifestation of venous thromboembolism (VTE). It has been estimated that there are 900,000 cases of pulmonary emboli (PE) and DVT per year resulting in 60,000 to 300,000 deaths. About two-thirds of VTE cases are associated with prolonged hospitalizations, emphasizing the importance of major surgery or immobilization as risk factors. METHODS: Retrospective study conducted in a Metropolitan Hospital. A total of 46 records were obtained from the hospital database following the established inclusion and exclusion criteria. For the control group a total of 42 records were selected. Patients included in this study were admitted with the diagnosis of deep venous thrombosis identified either by lower leg Doppler. RESULTS: Monocytosis with DVT, p-value was <0.001, with an Odd Ratio (OR) 9.35 and Interval Confidence (IC) 95% (3.2-27.3). The p-value for eosinophilia with DVT was 0.092, for males with DVT the p-value was 0.35 and age related groups with DVT value was 0.720. Sensitivity of monocytosis was 67.3%, specificity 80%, positive predictive value (PPV) 79.49% and negative predictive value (NPV) 63.9%. CONCLUSION: This study revealed the association between monocytosis and DVT, thus patients with monocytosis are more likely to develop DVT. This evidence is consistent with previous studies establishing that monocytes could have an important role with the coagulation cascade activation and the formation of DVT. The association of monocyte count and DVT can be used in the future as a significant tool in those patients with suspected DVT to increase diagnostic yield.

Posterior reversible leukoencephalopathy syndrome in hypertensive crisis complicated with seizure.

This is the case of a 32 year-old-male with chronic kidney disease in hemodialysis who presented with uncontrolled blood pressure after admission to the hospital further complicated with seizures. Head CT-Scan revealed hypodensives areas in sub-cortical white matter and parietal-occipital lobes. Posterior reversible leukoencephalopathy syndrome (PRES) was diagnosed by radiologic findings. The underlying cause of PRES was treated with good resolution of hypodensives areas. Good prognostic outcome of PRES depends on prompt recognition and treatment to avoid excessive morbidity and/or mortality.