GENETIC THROMBOPHILIA COMPLICATED BY VARICOSE VEIN THROMBOSIS AND THROPHIC ULCERS – A CLINICAL CASE REPORT
Keywords:Thrombophilia, Varicose veins, Thrombosis, Genetic factor, Anticoagulant therapy
Genetic factor is the leading in the development of varicose veins, although certain risk factors, including: overweight, old age, female gender, sedentary lifestyle, lower limb trauma and others contribute to its formation. Thrombophilia is a risk factor for the development of venous thrombosis and chronic recurrent trophic ulcer, although the relationship between them is not well understood. Hereditary thrombophilia is a rare disease characterized by severe complications. The correlation between thrombophilia, varicose veins, and chronic venous ulceration is quite strong. This paper describes the case of a 43-year-old man who was treated in the intensive care unit of the clinic in July 2019 with the diagnosis: thromboembolism of the pulmonary artery, thrombophilia, phlebitis and thrombosis in the phase of recanalization, with chronic venous insufficiency of the lower limbs, with a long history of varicose veins of both limbs and with diabetes mellitus. Faced complaints were: easy fatigue, weakness, shortness of breath, heart palpitations, feeling of heaviness and pain in the lower limbs, swelling. In the anamnesis - several cases of exacerbation of superficial vein thrombophlebitis were present. Despite the uncertain prognosis, remission was achieved on the background of intensive anticoagulation therapy. Considering recurrent thrombophlebitis, screening was prescribed. The case is interesting from both a theoretical and a practical point of view, since the described severe process became manageable - the acute form was transformed into a chronic one with a long remission. At this stage, the disease is not progressing, there are no additional complications.
Abildgaard U. Olav Egeberg-arvelig antitrombinmangel og trombofili [Olav Egeberg-hereditary antithrombin deficiency and thrombophilia]. Tidsskr Nor Laegeforen. 2001 Feb 20;121(5):604-5. Norwegian. PMID: 11301618.
Bradbury A W, MacKenzie R K, Burns P, Fegan C European Journal of Vascular and Endovascular Surgery. 2002; 24(2):97-104.
Encyclopedia of Respiratory Medicine 2006, 486-490.
Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011; 53(5):2S-48S.
Lucchi G, Bilancini S, Tucci S, Lucchi M. Superficial vein thrombosis in non-varicose veins of the lower limbs and thrombophilia. Phlebology. 2018 May; 33(4):278-281.
Milic DJ, Zivic SS, Bogdanovic DC, Karanovic ND, Golubovic ZV. Risk factors related to the failure of venous leg ulcers to heal with compression treatment. J Vasc Surg. 2009 May; 49(5):1242-1247.
Mitu F, Turcanu AM. Chronic venous insufficiency stage v ceap secondary to hereditary thrombophilia at a young man. Rev Med Chir Soc Med Nat Iasi. 2012 Oct-Dec; 116(4):1044-7.
Partsch H. Varicose veins and chronic venous insufficiency. Vasa. 2009 Nov; 38(4):293-301.
Robertson L, Lee AJ, Gallagher K, et al. Risk factors for chronic ulceration in patients with varicose veins: A case control study. J Vasc Surg. 2009 Jun; 49(6):1490-1498.
Schonauer V, Kyrle PA, Weltermann A, et al. Superficial thrombophlebitis and risk for recurrent venous thromboembolism. J Vasc Surg. 2003; 37(4):834-8.
Thornsberry LA, LoSicco KI, English JC 3rd. The skin and hypercoagulable states. J Am Acad Dermatol. 2013 Sep; 69(3):450-62.