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Pantic N, Cvetkovic M, Milin-Lazovic J, Vukmirovic J, Pavlovic A, Virijevic M, Pravdic Z, Kozarac S, Sabljic N, Suvajdzic-Vukovic N, Dragas M, Mitrovic M. Deep venous thrombosis in patients with atresia of the inferior vena cava and right kidney hypoplasia (KILT syndrome): Systematic review of the literature. Vasc Med 2024; 29:320-327. [PMID: 38573108 DOI: 10.1177/1358863x241240427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Inferior vena cava (IVC) anomalies are uncommon congenital causes of deep vein thrombosis (DVT). KILT syndrome (kidney and IVC abnormalities with leg thrombosis) has only been described as case reports in the literature. Therefore, the characteristics, evaluation, and management of patients with KILT syndrome have not yet been standardized. This study aimed to systematically review and analyze the clinical and radiographic data and treatment of previously reported cases of KILT syndrome. In this systematic review, we performed a literature search of the PubMed, Scopus, and Web of Science databases in December 2023, with no restrictions on the publication date. After duplicate extractions, 4195 articles were screened. Case reports and case series reporting on KILT syndrome were included. In addition to previously published cases, we included a new case of a previously healthy 25-year-old man with KILT syndrome in the analysis. A total of 34 cases were therefore included in this study. The majority (76.5%) were male patients with a median age of 24 years. In most patients, unprovoked bilateral iliofemoral thrombosis was diagnosed, and 64.7% had left kidney abnormalities. Our study suggests that anomalies of the IVC should be suspected in all young patients, especially male patients, with proximal, recurrent, or idiopathic DVT. If an IVC anomaly is confirmed, the kidneys should be examined to monitor and preserve healthy kidneys in cases of KILT syndrome. The data collected from all patients emphasize the requirement of long-term anticoagulation and risk factor control. Surgical measures may be effective for treating symptomatic refractory cases.
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Affiliation(s)
- Nikola Pantic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
| | - Mirjana Cvetkovic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
| | - Jelena Milin-Lazovic
- Faculty of Medicine, Institute for Medical Statistics and Informatics, University of Belgrade, Belgrade, Republic of Serbia
| | - Jelica Vukmirovic
- Center for Radiology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
| | - Aleksandar Pavlovic
- Center for Radiology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
| | - Marijana Virijevic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Republic of Serbia
| | - Zlatko Pravdic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
| | - Sofija Kozarac
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
| | - Nikica Sabljic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
| | - Nada Suvajdzic-Vukovic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Republic of Serbia
| | - Marko Dragas
- Faculty of Medicine, University of Belgrade, Belgrade, Republic of Serbia
- Clinic of Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Republic of Serbia
| | - Mirjana Mitrovic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Republic of Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Republic of Serbia
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Pichon M, Hij A, Wifaq B, Abderrahmane M, El Jarrari M, Menn AM. [Deep venous thrombosis caused by congenital inferior vena cava agenesis]. JOURNAL DE MEDECINE VASCULAIRE 2019; 44:79-85. [PMID: 30770086 DOI: 10.1016/j.jdmv.2018.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/18/2018] [Indexed: 06/09/2023]
Abstract
Congenital agenesis of the inferior vena cava, although rare, is found preferentially in young patients with proximal deep venous thrombosis. Exact diagnosis can be made thanks to enhanced computed tomography scan and/or magnetic resonance imaging, while Doppler ultrasonography is insufficient to establish an inferior vena cava malformation. A consensus has not yet been established for the treatment but lifelong anticoagulation with elastic stocking support to prevent post-thrombotic syndrome is commonly considered in most cases. We report a case of an unprovoked deep venous thrombosis caused by a congenital agenesis of the inferior vena cava localized to the infrarenal segment, in a 24-year-old man. An anticoagulation with low molecular weight heparin was started and prolonged oral anticoagulation was prescribed. In the absence of the usual thrombotic risk factors, the presence of an inferior vena cava anomaly should be considered.
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Affiliation(s)
- M Pichon
- Service de médecine polyvalente, centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel Prudhon, 95100 Argenteuil, France.
| | - A Hij
- Service de médecine interne et pathologie vasculaire, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - B Wifaq
- Service de médecine polyvalente, centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel Prudhon, 95100 Argenteuil, France
| | - M Abderrahmane
- Service de médecine polyvalente, centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel Prudhon, 95100 Argenteuil, France
| | - M El Jarrari
- Service de radiologie, centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel Prudhon, 95100 Argenteuil, France
| | - A-M Menn
- Service de médecine polyvalente, centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel Prudhon, 95100 Argenteuil, France
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Doganay S, Sonmezgoz F, Sen Y, Kocakoc E. Deep vein thrombosis associated with protein C and protein S deficiency: an unusual cause of acute abdomen. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:287-289. [PMID: 21547930 DOI: 10.1002/jcu.20771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 10/05/2010] [Indexed: 05/30/2023]
Abstract
Deep venous thrombosis is an extremely rare cause of acute abdomen and is often difficult to diagnose. Protein C and protein S deficiencies are rare genetic abnormalities that predispose the patient to thrombophilia and lead to thrombosis. We report the case of a previously healthy 7-year-old boy with iliofemoral thrombosis due to protein C and protein S deficiencies mimicking acute abdomen.
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Affiliation(s)
- Selim Doganay
- Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Baysoy G, Daar G, Demir H, Elmas SA, Haliloğlu M, Besbas N. Internal iliac vein thrombosis in pediatric Crohn's disease. J Crohns Colitis 2011; 5:57-9. [PMID: 21272806 DOI: 10.1016/j.crohns.2010.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 08/16/2010] [Accepted: 08/17/2010] [Indexed: 02/08/2023]
Abstract
Thromboembolic events are one of the important extraintestinal manifestations of inflammatory bowel diseases that are associated with considerable morbidity and mortality. Iliac vein thrombosis is rarely reported in inflammatory bowel diseases. A 9.5 year-old girl was presented with joint pain, nausea, vomiting and weight loss. She was diagnosed with Crohn's disease and right internal iliac vein thrombosis. With the implementation of immunosuppressive and anticoagulant therapies clinical picture has improved and thrombosis has resolved. Timely diagnosis and early treatment of extraintestinal complications of inflammatory bowel diseases might be lifesaving.
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Affiliation(s)
- Gokhan Baysoy
- Hacettepe University Medical Faculty, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Ankara, Turkey.
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Lambert M, Marboeuf P, Midulla M, Trillot N, Beregi JP, Mounier-Vehier C, Hatron PY, Jude B. Inferior vena cava agenesis and deep vein thrombosis: 10 patients and review of the literature. Vasc Med 2010; 15:451-9. [PMID: 21183652 DOI: 10.1177/1358863x10391355] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inferior vena cava agenesis (IVCA) is a rare condition, found in almost 5% of patients under 30 years old with unprovoked deep venous thrombosis (DVT). We describe 10 consecutive patients with IVCA-associated DVT and conducted an extensive literature review to investigate the typical spectrum of IVCA-associated DVT. Among our patients (eight men and two women; mean age, 25 ± 4.5 years), DVT followed intense and unusual (major) physical activity for eight of them. DVT was bilateral in six patients and unilateral in four. Ultrasonography was unable to detect IVCA, which was visualized by computed-tomography scans for seven patients, and magnetic resonance imaging and angiography for 10. Hereditary thrombophilia screening, to detect factor V Leiden or prothrombin gene heterozygosity (G20210A mutation), was positive for only two patients. Wearing elastic stockings and taking an indefinite or long-term vitamin K antagonist were prescribed for all 10 patients and nine complied with the latter. To date, 62 patients with IVCA-associated DVT have been reported in the English literature. Analysis of them and our patients yielded a typical spectrum of IVCA-associated DVT characteristics: IVCA occurs in young adults, particularly males, and is revealed by proximal DVT following major physical exertion. All were treated with a prolonged vitamin K antagonist and advised to wear elastic stockings. No precise duration of anticoagulation has been established.
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Affiliation(s)
- Marc Lambert
- Internal Medicine Department, Université Lille Nord de France, F-59037 Lille, France
| | - Philippe Marboeuf
- Vascular Medicine Department, Université Lille Nord de France, F-59037 Lille, France
| | - Marco Midulla
- Vascular Radiology Department, Université Lille Nord de France, F-59037 Lille, France
| | - Nathalie Trillot
- Hemostasis Laboratory, Centre Hospitalier Universitaire de Lille, Université Lille Nord de France, F-59037 Lille, France
| | - Jean-Paul Beregi
- Vascular Radiology Department, Université Lille Nord de France, F-59037 Lille, France
| | - Claire Mounier-Vehier
- Vascular Medicine Department, Université Lille Nord de France, F-59037 Lille, France
| | - Pierre-Yves Hatron
- Internal Medicine Department, Université Lille Nord de France, F-59037 Lille, France
| | - Brigitte Jude
- Hemostasis Laboratory, Centre Hospitalier Universitaire de Lille, Université Lille Nord de France, F-59037 Lille, France
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