Abstract
We describe a 45-year-old patient with massive pain and congestion in the lower limbs. In addition, he daily presented fever up to 39.5°C (103.1°F) without any infectious focus for 8 days. A formerly unknown vena cava atresia with severe bilateral deep vein thrombosis and concomitant heterozygous prothrombin (factor II) gene mutation (G20210A) was diagnosed during the hospital stay. Because of the severe clinical findings and hereditary thrombophilia, we recommended a lifelong anticoagulant therapy and elastic stockings. Furthermore, different diagnosis and treatment strategies are discussed in case of concomitant prothrombin gene mutation.
MeSH terms
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Anticoagulants / administration & dosage*
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Anticoagulants / therapeutic use
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Fever / blood*
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Fever / complications
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Fever / diagnostic imaging
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Fever / drug therapy
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Germany
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Heterozygote
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Humans
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Lower Extremity / diagnostic imaging
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Pain / blood*
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Pain / complications
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Pain / diagnostic imaging
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Pain / drug therapy
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Pain / genetics
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Point Mutation
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Prothrombin / genetics*
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Thrombophilia / blood*
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Thrombophilia / complications
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Thrombophilia / diagnostic imaging
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Thrombophilia / drug therapy
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Thrombophilia / genetics
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Ultrasonography, Doppler
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Vena Cava, Inferior / diagnostic imaging
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Venous Thrombosis / blood*
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Venous Thrombosis / complications
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Venous Thrombosis / diagnostic imaging
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Venous Thrombosis / drug therapy
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Venous Thrombosis / genetics
Substances
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Anticoagulants
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Prothrombin
Supplementary concepts
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Thrombophilia, hereditary