门静脉血栓患者的三重打击。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Archive of clinical cases Pub Date : 2024-05-14 eCollection Date: 2024-01-01 DOI:10.22551/2024.42.1101.10280
Elamein Yousif, Elamin Dahawi, Sarah Premraj, Wissem Melki
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引用次数: 0

摘要

感染 SARS-CoV-2 已被证明容易导致血栓栓塞事件。如果患者存在遗传性或获得性血栓前状态,发生血栓栓塞的风险会进一步增加。作者介绍了一位 30 岁的女士,她在轻度 COVID-19 感染痊愈三天后出现急性腹痛。她还在服用口服避孕药。实验室检查显示炎症指标升高,对比增强腹部 CT 扫描显示门静脉血栓形成(PVT)。由于血栓形成的部位不寻常,医生对她进行了血栓性疾病筛查,发现了杂合子因子 V Leiden 突变(FVL)。因此,她的 PVT 可归因于三个同时存在的危险因素,即 COVID-19 感染、使用 OCP 和 FVL 基因突变。她开始接受抗凝治疗,病情明显好转。对于出现非常见部位血栓的患者,在停用任何违规药物的同时,应考虑调查近期是否有感染Covid-19的证据,并筛查遗传性和获得性血栓性疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Triple whammy in a patient with portal vein thrombosis.

Infection with SARS-CoV-2 has been shown to predispose to thromboembolic events. The risk of such thromboses further increases in those with underlying inherited or acquired prothrombotic states. The authors present a 30-year-old lady who developed acute abdominal pain, three days after recovery from a mild COVID-19 infection. She was also using oral contraceptive pills. Laboratory investigations revealed elevated inflammatory markers, and a contrast-enhanced abdominal CT scan demonstrated portal vein thrombosis (PVT). Due to the unusual site of thrombosis, a thrombophilia screen was performed, which detected a heterozygous Factor V Leiden mutation (FVL). Thus, her PVT was attributed three simultaneous risk factors, namely COVID-19 infection, OCP use and FVL mutation. She was initiated on anti-coagulation, with which she improved significantly. In patients presenting with thromboses at uncommon sites, investigation for evidence of recent Covid-19 infection and screening for inherited and acquired thrombophilia should be considered, while discontinuing any offending medications.

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