Double-trouble: An unusual case of two simultaneous arterial thromboses in thrombophilia
Multiple arterial and venous thromboses are usually related to thrombophilia or antiphospholipid syndrome. Recurrent pulmonary embolism strongly indicates the presence of genetic or acquired thrombophilic factors. Simultaneous double arterial in situ thromboses are unusual, even in thrombophilic conditions. Simultaneous occurrence of pulmonary embolism and cerebrovascular ischaemic insult are highly indicative of existence of patent foramen ovale. We present herein a patient with the double simultaneous arterial thromboses as the manifestation of thrombophilia (heterozygous for methylenetetrahydrofolate-reductase (MTHFR) C677T gene mutation). There was no patent foramen ovale suspected upon the patient’s admittance to hospital. To the best of our knowledge there have been no similar cases presented to date.
KeywordsArterial thrombosis Simultaneous thromboses C677T methylenetetrahydrofolate reductase gene mutation Therapy Diagnosis
Unable to display preview. Download preview PDF.
- Goldhaber S.Z. Epidemiology of pulmonary embolism and deep vein thrombosis. In: Bloom A.L., Forbes C.D., Thomas D.P., Tuddenham E.G.D. (eds) Hemostasis and Thrombosis, 3rd ed. Edinburgh, UK: Churchill Livingstone, 2007, pp 1327–1333Google Scholar
- Charafeddine K.M., Mahfouz R.A., Ibrahim G.Y., Taher A.T., Hoballah J.J., Taha A.M. Massive pulmonary embolism associated with Factor V Leiden, prothrombin, and methylenetetrahydrofolate reductase gene mutations in a young patient on oral contraceptive pills: a case report. Clin Appl Thromb Hemost., 2010, 16, 594–598PubMedCrossRefGoogle Scholar
- Torbicki A., Perrier A., Konstantinides S., Agnelli G., Galiè N., Pruszczyk P., et al. ESC Committee for Practice Guidelines (CPG). Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J., 2008, 29, 2276–315PubMedCrossRefGoogle Scholar
- Kuisma M., Alaspaa A. Out of Hospital Cardiac Arrests of Non-Cardiac Origin: Epidemiology and Outcome. Eur Heart J., 1998, 18, 1122–1128Google Scholar