, Sung Kee Ryu, Jae Woong Choi, Dong Geum Shin, Yung Hee Lee, Hye Ran Kang, Won Young Chae, Ji Sang Park A 37-year-old female patient admitted due to dyspnea on exertion and peripheral edema. For one and a half years, the patient had been taking various drugs and supplements to reduce weight, including amphetamine-like drugs. The patient had no major cardiovascular risk factors except three pack-years of smoking. A chest computed tomography showed a 1.7 cm diameter, capsulated space-occupying lesion in the left ventricle (LV) and 2-dimensional echocardiography showed LV systolic dysfunction (Left ventricular ejection fraction [LVEF], 30%) with a mobile cystic mass (1.1×1.8 cm) that was attached to the LV apex, which was increased in size and number the next day, even with low dose low-molecular-weight heparin. With an increased dose of anticoagulation medication and heart failure management with diuretics and angiotensin receptor II blocker, LV dysfunction was recovered and the LV thrombus disappeared.
Citations
, Jung Yeon Lee, Su Jin Heo, Yoen Kyung Kee, Seung Hyeok Han Among the possible venous thromboembolic events in nephrotic syndrome, renal vein thrombosis and pulmonary embolism are common, while portal vein thrombosis (PVT) is rare. This report describes a 26-year-old man with histologically proven minimal change disease (MCD) complicated by PVT. The patient presented with epigastric pain and edema. He had been diagnosed with MCD five months earlier and achieved complete remission with corticosteroids, which were discontinued one month before the visit. Full-blown relapsing nephrotic syndrome was evident on laboratory and clinical findings, and an abdominal computed tomography revealed PVT. He immediately received immunosuppressants and anticoagulation therapy. An eight-week treatment resulted in complete remission, and a follow-up abdominal ultrasonography showed disappearance of PVT. In conclusion, PVT is rare and may not be easily diagnosed in patients with nephrotic syndrome suffering from abdominal pain. Early recognition of this rare complication and prompt immunosuppression and anticoagulation therapy are encouraged to avoid a fatal outcome.
, Jung Hoon Song, Kyung Pyo Cho, Jae Sung Lee, Yong Moon Woo, Beom Jin Jeong, Young Jun Cho, Yun Ju Han Splanchnic vein thrombosis arising from complications of acute pancreatitis is very rare. It usually occurs as a form of portal, splenic and superior mesenteric vein thrombosis, either in combination or separately. It could develop portal hypertension, bowel ischemia and gastrointestinal variceal bleeding. Treatment of splanchnic vein thrombosis includes anticoagulants, thrombolysis, insertion of shunts, bypass surgery and liver transplantation. In some cases, anticoagulation therapy may be considered to prevent complications. However, the standard protocol for anticoagulation in splanchnic vein thrombosis has not been determined yet. We report a case of 43-year-old man who had portal and splenic vein thrombosis in acute pancreatitis. The patient was successfully treated with oral anticoagulants following low molecular weight heparin therapy.
Citations
, Hye-Kyung Jung, Mi Yeon Kim, Min Sun Ryu, So Young Ahn, Hyoung Won Cho, In Sook Kang, Seong Eun Kim Antiphospholipid antibody syndrome (APS) is characterized by raised levels of antiphospholipid antibodies (aPL), in association with thrombosis, recurrent fetal loss, and thrombocytopenia. Development of APS is related with idiopathic origin, autoimmune disease, malignancy and, on rare occasions, infection. However, in secondary APS combined with bacterial infections, aPL is usually shown with low titer and rarely associated with thrombotic events. A 52-year-old male was admitted due to pneumonia and multiple hepatosplenic abscesses. He had been treated with proper antibiotics, but he presented ascites and sudden variceal bleeding because of portal vein thrombosis. The bleeding was controlled by endoscopic variceal ligation. Acute portal vein thrombosis was successfully managed by low molecular weight heparin and hepatosplenic abscesses were completely resolved by antibiotics. This case suggests that systemic bacterial infection in immunocompetent patients possibly develops into secondary APS.
, Jeong Soo Suh , Soo-Seung Choi To demonstrate a number of advantages of Gd-enhanced MR-venography with FISP techinuque in diagnosis of extremity deep vein thrombosis.
Gd-enhanced MR venography with FISP technique was performed in patients had deep venous thrombosis of lower limb. Findngs of MR venography was retrogradely analyzed.
Gd-enhanced MR-venography clearly demonstrates venous anatomy of the lower extremities in all cases. And, deep vein thrombosis was well detected with signal void filling defect. MR-venography also shows additional combined findings in deep vein thrombosis.
Gd-enhanced MR venography well demonstrates the anatomy of lower extremities and is a useful method for detection of deep vein thrombosis.
First
Prev
