Deep vein thrombosis in a 19-year-old patient with thrombophilia description of the diagnosis and treatment

Terpiłowski Michał, Tkaczyk Jędrzej, Klatka Barbara, Orzeł Anna, Janeczko Dominika, Hołowczuk Magdalena, Kęsik Jan, Iłżecki Marek. Deep vein thrombosis in a 19-year-old patient with thrombophilia - description of the diagnosis and treatment. Journal of Education, Health and Sport. 2019;9(8):773-778. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3407931

http://ojs.ukw.edu.pl/index.php/johs/article/view/7244

The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26/01/2017).

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

© The Authors 2019;

This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland

Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike.

(http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.

The authors declare that there is no conflict of interests regarding the publication of this paper.

Received: 05.07.2019. Revised: 25.07.2019. Accepted: 12.08.2019.

Deep vein thrombosis in a 19-year-old patient with thrombophilia ‑ description of the diagnosis and treatment

Michał Terpiłowski¹, Jędrzej Tkaczyk¹, Barbara Klatka¹, Anna Orzeł¹, Dominika Janeczko¹, Magdalena Hołowczuk¹, Jan Jakub Kęsik², Marek Iłżecki²

1. Students' Scientific Society at the Departament of Vascular Surgery and Angiology, Medical University of Lublin

2. Departament of Vascular Surgery and Angiology, Medical University of Lublin

Abstract

Introduction:

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in one of the body's deep veins, most commonly of the leg or pelvis. Before the fourth decade of life risk of DVT is low (about 1 per 10000). After the age of 45, it rises and approaches about 5 per 1000 by the age of 80. Noteworthy is the fact, that patients with a positive family history have a higher risk of DVT at a young age. Essential risk factors for developing DVT are genetic conditions or acquired thrombophilia and positive family history, but the lack of family predisposition cannot rule out the occurrence of DVT. Standard treatment method of DVT involves intravenous anticoagulation with the use of low molecular weight heparin and compression therapy. Apart from the above-mentioned methods, we can distinguish intermittent pneumatic compression, surgical embolectomy, pharmacomechanical thrombectomy, and venous stenting.

Case Report:

We present a case report of 19 - year old patient who was first admitted to hospital in April 2017 urgently with symptoms of pulmonary embolism which was confirmed in angio-CT. Moreover, in the Doppler ultrasound, left common iliac vein (LCIV), left external iliac vein (LEIV) and left femoral vein (LFV) thrombosis was diagnosed. During the hospitalization, genetic tests, antibody levels, and antithrombin levels were performed for thrombophilia and systemic diseases conducive to thrombosis. In October 2017 the angio-MR of the pelvis confirmed visible pressure on the LCIV, caused by the common iliac artery, which corresponds to the May-Turner syndrome. In March 2018 he was admitted to the clinic with DVT symptoms of the left lower limb such as swelling, pain, and redness. The patient underwent venous angioplasty and stent implantation for LCIV. The patient was discharged from hospital with recommendations such as compression therapy, Doppler ultrasonography and monitoring of INR.

Discussion:

Venous thrombosis is a multicausal disease: more than one risk factor needs to be present before thrombosis occurs. Choice of DVT treatment method is aimed at improving the quality of life of patients depending on clinical symptoms. venous stenting for an iliofemoral occlusive disease is a safe and effective method of treatment. It can be done with excellent patency rates expected in cases of idiopathic occlusion and May-Thurner syndrome. On this basis, the legitimacy of using venous stent implantation as an effective method of treatment of recurrent DVT episodes can be confirmed, which has been used in the described case

Key words: deep vein thrombosis; pharmacomechanical thrombectomy; thrombophilia