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Pérez Lázaro C, López-Bravo A, Gómez-Escalonilla Escobar C, Aguirre C, de Felipe A, de la Riva P, Calleja S, Arjona A, Serrano Ponz M, Navarro-Pérez MP, Delgado-Mederos R, Bashir Viturro S, Llul L, Egido J, García Madrona S, Díez González N, Benavente-Fernández L, de la Torre-Colmenero JD, Tejada Meza H, Vesperinas-Castro A, Sánchez-Cirera L, Trillo S. Management of cerebral venous thrombosis in Spain: MOTIVATE descriptive study. Neurologia 2024; 39:226-234. [PMID: 37442428 DOI: 10.1016/j.nrleng.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/22/2021] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults. Early, accurate diagnosis can reduce the rate and severity of complications. OBJECTIVE The aim of this study was to analyse the clinical characteristics, management, and treatment of CVT in different centres in Spain. METHODS We conducted a multicentre, retrospective, descriptive study of patients hospitalised due to CVT between 2008 and 2017 at 10 Spanish centres. RESULTS We included 256 patients, with a mean age (SD) of 49.8 (18.7) years; 51% of patients were women. The most frequent symptoms were headache (73%), focal deficits (50%), epileptic seizures (33%), and encephalopathy (21%). The most frequent localisations were the superior sagittal sinus (12.5%), the transverse sinus (10.9%), and 2 or more sinuses or veins (66.4%). Thrombophilia was the most frequent known aetiology (24%), and was most commonly associated with the prothrombin G20210A mutation (19%). Forty-six percent of patients were treated with antithrombotics for 3 to 6 months, 21% for one year, and 22.6% required indefinite anticoagulation. Endovascular therapy was performed in 5% of cases, and 33% required neurosurgery. Regarding outcomes, 75% of patients were independent at 3 months (modified Rankin Scale [mRS] score ≤ 2), with papilloedema (P = .03), focal deficits (P = .001), and encephalopathy (P < .001) showing a statistically significant association with poor prognosis (mRS > 3). The in-hospital mortality rate was 4.3%, with a 3-month mortality rate of 6.3%. CONCLUSION The diverse risk factors and variable presentation of CVT represent a challenge in the diagnosis and treatment of this condition. To improve prognosis and reduce mortality, it is essential to establish management protocols for this entity.
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Affiliation(s)
- C Pérez Lázaro
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain
| | - A López-Bravo
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain.
| | | | | | | | - P de la Riva
- Hospital Universitario Donosti, San Sebastián, Spain
| | - S Calleja
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Arjona
- Hospital Universitario Torrecárdenas, Almería, Spain
| | | | - M P Navarro-Pérez
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain
| | | | | | - L Llul
- Hospital Clínic, Barcelona, Spain
| | - J Egido
- Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | | | - H Tejada Meza
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - S Trillo
- Hospital La Princesa, Madrid, Spain
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Demelo-Rodríguez P, Ordieres-Ortega L, Oblitas CM. Mesenteric venous thrombosis. Med Clin (Barc) 2023; 160:400-406. [PMID: 36849315 DOI: 10.1016/j.medcli.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/27/2023]
Abstract
Mesenteric vein thrombosis (MVT) is a rare condition that can present acutely, subacutely, or chronically. MVT can be isolated or within a splanchnic thrombosis (spleno-porto-mesenteric). Symptomatic cases usually present as nonspecific abdominal pain, with or without signs of intestinal ischemia, and the diagnosis is usually made by imaging test (abdominal CT or MRI) in patients with high clinical suspicion. An early clinical-surgical approach is recommended to screen those patients with warning signs and who benefit from an exploratory laparotomy in addition to anticoagulant treatment, which is the cornerstone of medical treatment. MVT is usually associated with prothrombotic states, with hematological disorders (myeloproliferative syndromes and/or JAK2 gene mutations) being of special clinical relevance. On the other hand, the 5-year survival rate is 70-82% and early overall 30-day mortality from MVT can reach 20-32%.
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Affiliation(s)
- Pablo Demelo-Rodríguez
- Unidad de Enfermedad Tromboembólica Venosa, Departamento de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación, Hospital General Universitario Gregorio Marañón, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Facultad de Medicina, Universidad CEU San Pablo, Madrid, España.
| | - Lucía Ordieres-Ortega
- Unidad de Enfermedad Tromboembólica Venosa, Departamento de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación, Hospital General Universitario Gregorio Marañón, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - Crhistian-Mario Oblitas
- Unidad de Enfermedad Tromboembólica Venosa, Departamento de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación, Hospital General Universitario Gregorio Marañón, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Rueda-Camino JA, Gimena-Rodríguez FJ, Domínguez-Sepúlveda MA, Bolzoni M, Pastor-Vivas AI, Angelina-García M, Joya-Seijo MD, Trujillo-Luque D, Losada-Bayo D, Barba-Martín R. Retinal vein occlusion. Audit of a specialized care program. Rev Clin Esp 2023; 223:84-89. [PMID: 36646420 DOI: 10.1016/j.rceng.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/11/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Retinal vein occlusion (RVO) is the second most frequent cause of retinal vascular disease and is related to classic cardiovascular risk factors. A specific program was designed to detect and treat risk factors in patients with RVO. The aim of this study is to audit the results of this program. PATIENTS AND METHODS The program consisted of a multidisciplinary clinical evaluation by the Ophthalmology and Internal Medicine Departments. All patients with RVO were screened, at minimum, for hypertension, diabetes, dyslipidemia, smoking, overweight, and antiphospholipid syndrome. New risk factors or poor control of known risk factors were expected to be found in at least one-third of the patients. Among them, therapeutic measures were expected to be taken in at least two-thirds. A dissociated automated search of the data of all patients who entered the program between April 2021 and April 2022 was performed. RESULTS Fifty-six patients were included for analysis. Of these, 39 (69.6%) had at least one new or poorly controlled risk factor and 43 (76.8%) had their treatment modified in some way. Antiphospholipid syndrome was detected in five (8.9%). Only one patient had low-risk hereditary thrombophilia. After an exhaustive examination, no risk factors were found in 11 patients. CONCLUSION This specific program has been effective in detecting new or poorly controlled risk factors and improving their treatment.
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Affiliation(s)
- J A Rueda-Camino
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain.
| | - F J Gimena-Rodríguez
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M A Domínguez-Sepúlveda
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M Bolzoni
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - A I Pastor-Vivas
- Servicio de Oftalmología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M Angelina-García
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - M D Joya-Seijo
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - D Trujillo-Luque
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - D Losada-Bayo
- Servicio de Oftalmología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - R Barba-Martín
- Unidad Multidisciplinar de Enfermedad Tromboembólica Venosa, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
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Sanlés González I, Napal Lecumberri JJ, Pérez-Montes R, Cerveró Varona A, Casado Rojo A, Hernández Hernández JL. Retinal vein occlusion in patients under 50 years. Analysis of vascular risk factors, thrombophilia, carotid ultrasound findings and uncommon aetiologies. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:443-449. [PMID: 35618638 DOI: 10.1016/j.oftale.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/21/2021] [Indexed: 06/15/2023]
Abstract
INTRODUTION Retinal vein occlusion (RVO) has been related to vascular risk factors and thrombophilia. METHODS This is a prospective cohort study of all patients diagnosed with RVO and referred to an Internal Medicine clinic of a tertiary teaching hospital during a 10-year period. Clinical, laboratory and supra-aortic trunks ultrasound variables were analysed and compared according to age. RESULTS Some 309 patients diagnosed with RVO were included, 25 of them younger than 50 years. The prevalence of high blood pressure, dyslipidaemia, diabetes mellitus, hyperhomocysteinemia, and carotid plaque was significantly higher in patients >50 years than in those below. However, the prevalence of inherited thrombophilia was higher in the younger group (32.0% vs 11.4%; p = 0.005). Uncommon diseases related to RVO such as hepatitis C, thalassemia minor, Lyme disease, vasculitis, and periphlebitis were observed in young patients without vascular risk factors. CONCLUSION We suggest performing a genetic thrombophilia study in RVO patients younger than 50 years, while an exhaustive control of vascular risk factors is always recommended in all RVO patients. Moreover, we suggest bearing in mind uncommon diseases related to RVO, especially in young patients without vascular risk factors.
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Affiliation(s)
- I Sanlés González
- Departmento de Medicina Interna, Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - J J Napal Lecumberri
- Departmento de Medicina Interna, Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - R Pérez-Montes
- División de Hematología, Hospital Marqués de Valdecilla, Santander, Spain
| | - A Cerveró Varona
- Departamento de Oftalmología, Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain.
| | - A Casado Rojo
- Departamento de Oftalmología, Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain
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García Palacios JD, Puente Ruiz N, Napal Lecumberri JJ, Hernández Hernández JL. Effects of the COVID-19 pandemic on a cohort of patients with vein occlusion. Rev Clin Esp 2021; 221:587-591. [PMID: 34565709 PMCID: PMC8450061 DOI: 10.1016/j.rceng.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
Background and objectives A new coronavirus disease in humans, COVID-19, caused by SARS-CoV-2, emerged in December 2019. It has been associated with the development of thrombotic phenomena. Retinal vein occlusion (RVO) is mainly a consequence of vascular risk factors (VRF). This study aimed to analyze cases of COVID-19 in a cohort of patients with RVO (Valdecilla cohort). Patients and methods Between December 2008 and December 2020, 429 patients with RVO were attended to in our clinic. Ten patients had COVID-19, one of which did not have VRF or thrombophilia. The remaining nine patients had RVO prior to the infection and VRF, six had carotid atherosclerosis, and four had antiphospholipid syndrome. The infection did not cause thrombotic phenomena in any of them. Conclusions RVO is a rare manifestation of COVID-19. In our cohort of patients with RVO, COVID-19 disease did not lead to thrombotic events.
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Affiliation(s)
- J D García Palacios
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Cantabria, Spain.
| | - N Puente Ruiz
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Cantabria, Spain
| | - J J Napal Lecumberri
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Cantabria, Spain
| | - J L Hernández Hernández
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Cantabria, Spain; Universidad de Cantabria, Santander, Cantabria, Spain
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Pérez Lázaro C, López-Bravo A, Gómez-Escalonilla Escobar C, Aguirre C, de Felipe A, de la Riva P, Calleja S, Arjona A, Serrano Ponz M, Navarro-Pérez MP, Delgado-Mederos R, Bashir Viturro S, Llul L, Egido J, García Madrona S, Díez González N, Benavente Fernández L, de la Torre Colmenero JD, Tejada Meza H, Vesperinas Castro A, Sánchez Cirera L, Trillo S. Management of cerebral venous thrombosis in Spain: MOTIVATE descriptive study. Neurologia 2021:S0213-4853(21)00116-X. [PMID: 34511275 DOI: 10.1016/j.nrl.2021.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/29/2021] [Accepted: 05/22/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults. Early, accurate diagnosis can reduce the rate and severity of complications. OBJECTIVE The aim of this study was to analyse the clinical characteristics, management, and treatment of CVT in different centres in Spain. METHODS We conducted a multicentre, retrospective, descriptive study of patients hospitalised due to CVT between 2008 and 2017 at 11 Spanish centres. RESULTS We included 256 patients, with a mean age (SD) of 49.8 (18.7) years; 51% of patients were women. The most frequent symptoms were headache (73%), focal deficits (50%), epileptic seizures (33%), and encephalopathy (21%). The most frequent localisations were the superior sagittal sinus (12.5%), the transverse sinus (10.9%), and 2 or more sinuses or veins (66.4%). Thrombophilia was the most frequent known aetiology (24%), and was most commonly associated with the prothrombin G20210A mutation (19%). Forty-six percent of patients were treated with antithrombotics for 3-6 months, 21% for one year, and 22.6% required indefinite anticoagulation. Endovascular therapy was performed in 5% of cases, and 33% required neurosurgery. Regarding outcomes, 75% of patients were independent at 3 months (modified Rankin Scale [mRS] score ≤ 2), with papilloedema (P=.03), focal deficits (P=.001), and encephalopathy (P <.001) showing a statistically significant association with poor prognosis (mRS> 3). The in-hospital mortality rate was 4.3%, with a 3-month mortality rate of 6.3%. CONCLUSION The diverse risk factors and variable presentation of CVT represent a challenge in the diagnosis and treatment of this condition. To improve prognosis and reduce mortality, it is essential to establish management protocols for this entity.
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Affiliation(s)
- C Pérez Lázaro
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, España
| | - A López-Bravo
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, España.
| | | | - C Aguirre
- Hospital La Princesa, Madrid, España
| | | | - P de la Riva
- Hospital Universitario Donosti, San Sebastián, España
| | - S Calleja
- Hospital Universitario Central de Asturias, Oviedo, España
| | - A Arjona
- Hospital Universitario Torrecárdenas, Almería, España
| | | | - M P Navarro-Pérez
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, España
| | | | | | - L Llul
- Hospital Clínic, Barcelona, España
| | - J Egido
- Hospital Clínico San Carlos, Madrid, España
| | | | | | | | | | - H Tejada Meza
- Hospital Universitario Miguel Servet, Zaragoza, España
| | | | | | - S Trillo
- Hospital La Princesa, Madrid, España
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Hubert A, Guéret P, Leurent G, Martins RP, Auffret V, Bedossa M. Myocardial infarction and thrombophilia: Do not miss the right diagnosis! Rev Port Cardiol 2017; 37:89.e1-89.e4. [PMID: 29254740 DOI: 10.1016/j.repc.2016.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 12/12/2016] [Accepted: 12/14/2016] [Indexed: 11/20/2022] Open
Abstract
Protein C deficiency is a coagulation cascade disorder often resulting in venous thromboembolic events but is also a possible contributor to arterial thrombosis. To date, approximately ten cases of myocardial infarction (MI) due to protein C deficiency have been reported in the literature. However, affirming this mechanism requires ruling out the most common causes of MI, i.e. the rupture or erosion of an atherosclerotic plaque. Intravascular imaging of coronary arteries can be of help to identify angiographically undetected atherosclerosis. We report a case of an ST-segment elevation myocardial infarction (STEMI) in a young man with apparent evidence of arterial thrombosis resulting from protein C deficiency and heterozygous factor Leiden mutation which was contradicted by intravascular imaging demonstrating atherosclerosis.
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Affiliation(s)
- Arnaud Hubert
- Centre Hospitalier Universitaire (CHU) de Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes, France; Université de Rennes 1, Laboratoire Traitement du Signal et de l'Image (LTSI), Rennes, France; Institut National de la Santé et de la Recherche Médicale (Inserm), Rennes, France.
| | - Pierre Guéret
- Centre Hospitalier Universitaire (CHU) de Rennes, Laboratoire d'Hématologie-Hémostase, Rennes, France
| | - Guillaume Leurent
- Centre Hospitalier Universitaire (CHU) de Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes, France; Université de Rennes 1, Laboratoire Traitement du Signal et de l'Image (LTSI), Rennes, France; Institut National de la Santé et de la Recherche Médicale (Inserm), Rennes, France
| | - Raphael P Martins
- Centre Hospitalier Universitaire (CHU) de Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes, France; Université de Rennes 1, Laboratoire Traitement du Signal et de l'Image (LTSI), Rennes, France; Institut National de la Santé et de la Recherche Médicale (Inserm), Rennes, France
| | - Vincent Auffret
- Centre Hospitalier Universitaire (CHU) de Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes, France; Université de Rennes 1, Laboratoire Traitement du Signal et de l'Image (LTSI), Rennes, France; Institut National de la Santé et de la Recherche Médicale (Inserm), Rennes, France
| | - Marc Bedossa
- Centre Hospitalier Universitaire (CHU) de Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes, France; Université de Rennes 1, Laboratoire Traitement du Signal et de l'Image (LTSI), Rennes, France; Institut National de la Santé et de la Recherche Médicale (Inserm), Rennes, France
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Pascual-Camps I, Hernández-Martínez P, Dolz-Marco R, Gallego-Pinazo R. Systematic study of retinal vein occlusion in young patients. Case report and review of the literature. Arch Soc Esp Oftalmol 2016; 91:130-3. [PMID: 26706778 DOI: 10.1016/j.oftal.2015.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 06/05/2015] [Accepted: 10/31/2015] [Indexed: 11/21/2022]
Abstract
PURPOSE To report the case of a young woman with retinal vein occlusion and prothrombin heterozygous mutation, and to review the current evidence on the systematic study in cases of retinal vein occlusion (RVO) in young patients. METHODS Eligible articles were identified using a comprehensive literature search of PubMed. CONCLUSION RVO risk factors may have different relevance depending on each age group. In the systematic study of cases in young patients, it is recommended to look for "emerging" risk factors, bilateral involvement, or absence of "classic" risk factors.
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Borrego-Sanz L, Santos-Bueso E, Sáenz-Francés F, Martínez-de-la-Casa JM, García-Feijoo J, Gegúndez-Fernández JA, García-Sánchez J. Retinal venous thrombosis in a young patient with coagulation factor XII deficiency. ACTA ACUST UNITED AC 2013; 89:329-31. [PMID: 24269423 DOI: 10.1016/j.oftal.2013.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 06/08/2013] [Accepted: 06/11/2013] [Indexed: 11/20/2022]
Abstract
CASE REPORT A 35-year-old woman, with no relevant medical history, was referred for sudden vision loss in the left eye. Ophthalmological examination showed best corrected visual acuity of 1.0 in the right eye and 0.3 in left eye, with normal anterior pole and intraocular pressure. Fundus examination of the left eye revealed a venous thrombosis in the superior temporal branch, with dilated and tortuous retinal veins. The patient was referred to the hematology unit for thrombophilia study, and was diagnosed with a coagulation XII or Hageman factor deficiency. DISCUSSION The development of retinal vessel occlusions, in patients under 50 years of age, is frequently associated with thrombophilia or hypercoagulability disorders. Factor XII deficiency is a rare condition, and its presence could contribute to a higher risk of thromboembolic events.
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Affiliation(s)
- L Borrego-Sanz
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España.
| | - E Santos-Bueso
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - F Sáenz-Francés
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J M Martínez-de-la-Casa
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J García-Feijoo
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J A Gegúndez-Fernández
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J García-Sánchez
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
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