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Rev Med Interne ; 41(9): 628-631, 2020 Sep.
Artigo em Francês | MEDLINE | ID: mdl-32565074

RESUMO

INTRODUCTION: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease characterized by the triad of nose bleeding, telangiectasia and familial heredity. CASE REPORT: We report the case of a patient who had idiopathic venous cerebral thrombosis complicated by a cerebral infarction treated with warfarin. In the context of a psoas hematoma by warfarine overdose and immobilization, the patient had deep vein thrombosis of the left lower limb with pulmonary embolism revealing a pulmonary arteriovenous malformation. After a reexamination, the patient clinical phenotype of HHT was confirmed genetically. The patient was treated with rivaroxaban allowing clinical improvement and partial recanalization of all thrombosis after six months. Thrombotic overisk has already been studied in HHT patients but the use of anticoagulants is at higher risk in these patients. However this patient experienced no adverse event with rivaroxaban. CONCLUSION: This is the first case described of cerebral venous thrombosis treated with rivaroxaban revealing an HHT.


Assuntos
Trombose Intracraniana/etiologia , Telangiectasia Hemorrágica Hereditária/diagnóstico , Trombose Venosa/etiologia , Anticoagulantes/uso terapêutico , Fístula Arteriovenosa/diagnóstico , Fístula Arteriovenosa/tratamento farmacológico , Fístula Arteriovenosa/etiologia , Diagnóstico Tardio , Diagnóstico Diferencial , Humanos , Trombose Intracraniana/diagnóstico , Trombose Intracraniana/tratamento farmacológico , Transtornos de Início Tardio , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Artéria Pulmonar/anormalidades , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamento farmacológico , Embolia Pulmonar/etiologia , Veias Pulmonares/anormalidades , Rivaroxabana/uso terapêutico , Telangiectasia Hemorrágica Hereditária/complicações , Telangiectasia Hemorrágica Hereditária/tratamento farmacológico , Trombose Venosa/diagnóstico , Trombose Venosa/tratamento farmacológico
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