- 期刊
Familial Hyperhomocysteinemia-related Cerebral Venous Sinus Thrombosis and Pulmonary Embolism: A Case Report
並列摘要
Elevated plasma homocysteine levels are associated with an increased risk of deep vein trombosis. Herein we report a case of familial hyperhomocysteinemia-related cerebral venous sinus thrombosis and pulmonary embolism in a 21-year-old man who presented with severe headache over bilateral frontal areas. Neurological examination revealed no evidence of focal neurological deficit. Chest CT showed pulmonary thromboembolism in bilateral basal lung fields and brain MRI disclosed right transverse and sigmoid venous sinus thrombosis. Routine immunological tests, coagulation factors and occult tumor screening were normal, as were vitamin B12 and folate levels. The DIC profile was negative, The only risk factor we were able to identify was an elevated serum homocysteine level, namely 46.23 μM/L. Hyperhomocysteinemia was also noted in the patient's asymptomatic elder brother (68.0 μM/L) and, to a lesser extent, in his parents (father 12.5 μM/L; mother 11.7 μM/L). In conclusion, the cause of cerebral venous thrombosis and pulmonary embolism in this young patient was most likely related to familial hyperhomocysteinemia, with the thromboembolic events precipitated by a preceding systemic infection. After anticoagulation therapy; the patient recovered completely without any residual neurological deficit.
延伸閱讀
- Yeh, F. J., Lee, C. W., & Tang, S. C. (2020). Cerebral Venous Sinus Thrombosis Caused by Hereditary Protein S Deficiency: A Case Report. 台灣中風醫誌, 2(3), 249-254. https://doi.org/10.6318/FJS.202009_2(3).0007
- 黃士益、陳天文、黃茂雄（2011）。Cerebral Venous Thrombosis with Cerebral Arterial Infarction during Pregnancy: A Case Report。台灣復健醫學雜誌，39(4)，259-263。https://doi.org/10.6315/2011.39(4)09
- Yu, P. T., Chen, C. Y., & Lin, C. Y. (2019). Uterine Myoma - Induced Venal Thrombosis and Acute Pulmonary Thromboembolism: 2 Case Reports. 胸腔醫學, 34(3), 133-138. https://www.airitilibrary.com/Article/Detail?DocID=10239855-201906-201905280015-201905280015-133-138
- 黃錚暉、黃亮瑋、高木榮、徐會棋、王德珍、王榮俊（2008）。Paroxysmal Nocturnal Hemoglobinuria Complicated by an Arterial Cerebral Infarction: A Case Report。台灣復健醫學雜誌，36(2)，127-133。https://doi.org/10.6315/2008.36(2)08
- Chin, W. L., Liu, I. T., Lin, C. W., Wang, H. K., Sun, C. K., & Hung, W. C. (2018). Brain Abscess as the First Clinical Manifestation of Isolated Pulmonary Arteriovenous Malformation without Hereditary Hemorrhagic Telangiectasia: A Case Report. 台灣家庭醫學雜誌, 28(1), 38-44. https://doi.org/10.3966/168232812018032801005