MyMedR

Fulltext Rare cause of lower limb deep venous thrombosis: a case report

Khang NC, Hanif H, Zainal Ariffin A

Med J Malaysia, 2014 Jun;69(3):144-5.

deep venous thrombosis (dVT) in lower limbs caused by abdominal aortic aneurysm (AAA) is rare. A combination of anatomical obstruction with surrounding inflammatory tissue and reduced blood flow in venous limb were probably the main reasons for the occurrence of the dVT. we report a case of infra-renal AAA presented as lower limb dVT and symptomatic pulmonary embolism.

Matched MeSH terms: Venous Thrombosis

Fulltext Spontaneous calf haematoma: case report

Zubaidah NH, Liew NC

Med J Malaysia, 2014 Feb;69(1):44-5.

PMID: 24814632 MyJurnal

Spontaneous calf haematoma is a rare condition and few case reports have been published in the English literature. Common conditions like deep vein thrombosis and traumatic gastrocnemius muscle tear need to be considered when a patient presents with unilateral calf swelling and tenderness. Ultrasound and Magnetic Resonance Imaging are essential for confirmation of diagnosis. The purpose of this paper is to report on a rare case of spontaneous calf hematoma and its diagnosis and management.

Matched MeSH terms: Venous Thrombosis

Fulltext A rare cause of pain in the perineum

Syed Alwi SA, Zainal AA, Lau JH

Med J Malaysia, 2015 Feb;70(1):45-7.

PMID: 26032531 MyJurnal

Isolated internal iliac aneurysms are rare. We report a case of an uncommon presentation of perineal pain and tenesmus in a man caused by the pressure effects of the aneurysm. He had a successful endovascular exclusion and thrombosis of his aneurysm. On follow up of more than 3 years he remains free of all symptoms and no recurrence of the aneurysm.

Matched MeSH terms: Thrombosis

Fulltext Obstruction of mechanical heart valve--diagnosis, surgical treatment and outcome

Pau KK, Yakub A, Sallehuddin A, Awang Y

Med J Malaysia, 2001 Jun;56(2):196-200.

PMID: 11771080

From 1982 till 1999, our department performed a total of 2970 heart valve replacements--92% of which were with mechanical heart valves. During this period, there were 8 patients who came to our department with mechanical heart valve obstruction. All these patients presented with signs of heart failure or compromised haemodynamic. Confirmatory tests included transthoracic or transoesophageal echocardiography and cine fluoroscopy. Seven patients were operated upon urgently. Four of the patients had valve thrombosis. The time interval between the initial implantation and presentation varies from 4 months to 11.3 years. Six of the seven patients who were operated on recovered well from the surgery.

Matched MeSH terms: Thrombosis/diagnosis*; Thrombosis/mortality; Thrombosis/surgery*

Fulltext Case Report: The Use of Intravenous SMOFlipid Infusion to Treat Severe Asparaginase-Induced Hypertriglyceridemia in Two Pediatric Acute Lymphoblastic Leukemia Patients

Lau SCD, Loh CK, Alias H

Front Pediatr, 2021;9:660627.

PMID: 33968859 DOI: 10.3389/fped.2021.660627

Asparaginase-induced hypertriglyceridemia can have a spectrum of clinical presentations, from being asymptomatic to having life-threatening thrombosis or hyperviscosity syndrome. At present, there is no recommendation on routine lipid monitoring during asparaginase-containing treatment phase, nor a standardized guideline on its management. Two cases are presented here to illustrate the effects of concurrent infection on asparaginase-induced hypertriglyceridemia in patients with high-risk ALL and the use of SMOFlipid infusion as a treatment option in an acute situation.

Matched MeSH terms: Thrombosis

Cerebral venous sinus thrombosis: review of cases in a single centre in Malaysia

Sim SK, Tan YC, Ghani ARI

Med J Malaysia, 2020 01;75(1):38-42.

PMID: 32008018

INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a potentially fatal neurological condition. However, due to the non-specific clinical and radiological features of CVST, it can sometimes result in a delay in the diagnosis and subsequent management. The aim of this study was to evaluate the demography, risk factors and one-year outcome of CVST patients treated in Hospital Universiti Sains Malaysia.

METHODS: In this retrospective study, we reviewed the cases diagnosed with CVST admitted to our centre from January 2011 until November 2015.

RESULTS: A total of 15 patients were included in this review. The patterns of imaging findings as well as risk factors for CVST is discussed with a review of the literature and current management practices. One year followed-up showed full recovery (Glasgow Outcome Scale (GOS) of 5) in 10 cases (66.7%), whereas 4 cases (26.7%) with GOS of 4 (three cases with neurological deficits, and 1 case with mild symptom. There was one case of mortality in this study secondary to sepsis during hospitalisation. The presenting symptoms were mainly headache, focal neurology deficits, seizure and altered sensorium. Risk factors identified were oral contraceptive pills usage, chronic sinuses or ear infections, and obesity. Initial computed tomography (CT) scan showed various findings and haemorrhagic infarct was one of the common findings. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) revealed majority of the patients had occlusion at two or more venous sinus sites. No patients had new or recurrent intracranial haemorrhage following initiation of anticoagulation therapy.

CONCLUSION: Thus it is considerable safe to start anticoagulation therapy in CVST patients including those with intracranial haemorrhage. We propose further neuroimaging to avoid missed diagnosis of CVST in patient presented with recent onset headache and CT evidence of unusual cerebral infarction.

Matched MeSH terms: Sinus Thrombosis, Intracranial/diagnosis*; Sinus Thrombosis, Intracranial/drug therapy*; Sinus Thrombosis, Intracranial/etiology

Fulltext Inferior vena cava tumour thrombectomy by novel endovascular approach

Shahril, K., Reynu, R., Kosai, N.R., Bong, J.J., Rozman, Z., Yazmin, Y., et al.

Medicine & Health, 2015;10(2):151-155.

MyJurnal

The presence of thrombus within the inferior vena cava (IVC) is often a sign of advance hepatocellular carcinoma (HCC). Various treatment methods have been described with variable and inconclusive results. Now, the advancement of endovascular approach offers new possibility as a potential treatment modality. We discuss the removal of tumour thrombus with catheter directed mechanical thrombectomy. IVC tumour secondary HCC was removed by AngioJet® rheolytic system (Possis Medical, Minneapolis, MN, USA) with good result. Further work should be encouraged to explore the prospect of this technique with other treatment modalities.

Matched MeSH terms: Thrombosis

Treatment of chronic total occlusions in native coronary arteries by drug-coated balloons without stenting - A feasibility and safety study

Köln PJ, Scheller B, Liew HB, Rissanen TT, Ahmad WA, Weser R, et al.

Int J Cardiol, 2016 Dec 15;225:262-267.

PMID: 27741486 DOI: 10.1016/j.ijcard.2016.09.105

Chronic total occlusions remain one of the biggest challenges for interventional cardiologists and the high risk of restenosis and stent thrombosis is still a major problem. Drug-coated balloons showed favorable results for the treatment of in-stent restenosis and other lesion types. The aim of this study was to evaluate the feasibility and outcome of a drug-coated balloon only approach for chronic total occlusion.

Matched MeSH terms: Thrombosis

Fulltext Cerebral venous sinus thrombosis in a patient with concomitant Graves' disease and squamous cell carcinoma of the cervix

Chee YC, Abdul Halim S

BMJ Case Rep, 2020 Dec 09;13(12).

PMID: 33298481 DOI: 10.1136/bcr-2020-236730

Cerebral venous sinus thrombosis (CVST) is caused by either acquired or inherited pro-thrombotic states. Hyperthyroidism is a less recognised predisposing factor of CVST, and the causality has been debated. We report a case of a life-threatening CVST in a 40-year-old woman, with uncommon dual risk factors: hyperthyroidism and advanced squamous cell carcinoma of the cervix. CVST should be considered as a differential diagnosis when a patient with hyperthyroidism presents with new-onset headache or other neurological symptoms. Further assessment to elucidate other covert risk factors may need to be continuously carried out, when the causal relationship of one apparent cause has not been well established.

Matched MeSH terms: Sinus Thrombosis, Intracranial/diagnosis; Sinus Thrombosis, Intracranial/etiology*; Sinus Thrombosis, Intracranial/therapy

Fulltext Lateral sinus thrombosis

Nurliza I, Saim L

Med J Malaysia, 2007 Aug;62(3):245-6.

PMID: 18246917 MyJurnal

We describe four cases of lateral sinus thrombosis secondary to otitis media. They presented with low-grade fever, headache, nausea, vomiting and ear discharge. One patient had facial nerve palsy. CT scan was helpful in managing these patients. They were treated with antibiotics followed by surgery. Two patients had intracranial abscesses and were treated accordingly.

Matched MeSH terms: Lateral Sinus Thrombosis/diagnosis; Lateral Sinus Thrombosis/drug therapy; Lateral Sinus Thrombosis/pathology*; Lateral Sinus Thrombosis/surgery

An uncommon mediastinal cyst with a rare neurologic consequence

Sivalingam S, Qureshi AU, Chern LM, Latiff HA

Ann Thorac Surg, 2014 Apr;97(4):e93-5.

PMID: 24694456 DOI: 10.1016/j.athoracsur.2013.12.060

Enteric cysts are uncommon posterior mediastinal cysts, usually presenting with respiratory symptoms in infancy. We present a rare case of posterior mediastinal enteric cyst extending from below the diaphragm and perforating into the left atrium, causing a thromboembolic cerebral infarct in a 5-year-old boy.

Matched MeSH terms: Intracranial Thrombosis/etiology*

Fulltext Successful treatment of perioperative very late stent thrombosis with thromboaspiration device

Yew KL

Med J Malaysia, 2012 Jun;67(3):351.

PMID: 23082437

Matched MeSH terms: Thrombosis/therapy*

Fulltext Perioperative very late stent thrombosis treated with thrombosuction

Sikdar S, Kumar D, Basu S, Mohanty V, Naik J, Banerjee S

Med J Malaysia, 2012 Feb;67(1):129-30.

PMID: 22582568

Matched MeSH terms: Thrombosis/therapy*

Bilateral ophthalmic vein thrombosis secondary to nasal furunculosis

Rohana AR, Rosli MK, Nik Rizal NY, Shatriah I, Wan Hazabbah WH

Orbit, 2008;27(3):215-7.

PMID: 18569833 DOI: 10.1080/01676830802009754

We were presented with a teenage female who developed superior ophthalmic vein thrombosis and cavernous sinus thrombophlebitis after a 1-week history of a single acne-like lesion or furuncle at the anterior tip of the nose. She was managed aggressively with heparin and intravenous antibiotic. Signs and symptoms improved after 2 weeks of treatment, and she was discharged with an anticoagulant.

Matched MeSH terms: Cavernous Sinus Thrombosis/drug therapy; Cavernous Sinus Thrombosis/etiology*; Cavernous Sinus Thrombosis/radiography; Venous Thrombosis/drug therapy; Venous Thrombosis/etiology*; Venous Thrombosis/radiography

Acute myelomonocytic leukaemia complicated by an acute aortic thrombosis

Leong KW, Bosco JJ, Shaik IB

Postgrad Med J, 1995 Feb;71(832):112-3.

PMID: 7724422

Acute aortic thrombosis is a rare condition, occurring mainly as a result of trauma or atherosclerosis and occasionally secondary to hypercoagulable states. We report a patient with relapsed acute myeloid leukaemia who developed an unusual complication, acute aortic thrombosis.

Matched MeSH terms: Thrombosis/complications*

A thrombosed saccular posterior cerebral artery aneurysm in an infant

Cheung H, Lee FC

Australas Radiol, 1993 Feb;37(1):90-2.

PMID: 8323524

A case of recurrent hemiplegia due to saccular aneurysm of the left posterior cerebral artery in a female infant is described. The diagnosis was made at angiography, prompted by CT detection of a hyperdense, intra-aneurysmal thrombus, and was confirmed at subsequent surgery.

Matched MeSH terms: Intracranial Embolism and Thrombosis/complications

Fulltext Behcet's syndrome with sagittal sinus and inferior vena caval thrombophlebitis

Segasothy M

Med J Malaysia, 1982 Jun;37(2):132-3.

PMID: 7132832

This report describes a case of Behcet's syndrome in which there was involvement of both the intracranial and systemic veins. The pathogenesis of Behcet's syndrome is discussed.

Matched MeSH terms: Sinus Thrombosis, Intracranial/complications*

Fulltext Use of low-molecular-weight heparin in COVID-19 patients

Kow CS, Hasan SS

J Vasc Surg Venous Lymphat Disord, 2020 09;8(5):900-901.

PMID: 32561464 DOI: 10.1016/j.jvsv.2020.06.006

Matched MeSH terms: Venous Thrombosis*

Fulltext An uncommon cause of leg swelling after exercise: a case report on an unprovoked deep vein thrombosis in young healthy man

Rathika Rajah, Alvin Oliver Payus, Norlaila Mustafa

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):351-353.

MyJurnal

Antiphospholipid syndrome is a hypercoagulable autoimmune condition that predominantly affect the female and commonly manifest as arterio-venous thrombosis and recurrent miscarriage. Here, we present a unique case of a healthy young man who developed sudden onset of right leg swelling after exercise which was then found to be due to deep vein thrombosis via Doppler ultrasound. His blood investigations showed thrombocytopenia and prolonged coagulation profile. Therefore, antiphospholipid syndrome was suspected and later confirmed by positive autoim- mune antibodies. He was treated with long term moderate intensity oral warfarin. The objective of this case report is to share the uncommon occurrence of an unprovoked deep vein thrombosis secondary to antiphospholipid syn- drome in a healthy young man so that the possibility of deep vein thrombosis should be suspected in selected cases of non-resolving leg swelling after exercise as it can lead to fatal pulmonary embolism.

Matched MeSH terms: Thrombosis; Venous Thrombosis

Fulltext Isolation, Purification, and Characterization of Heparinase from Streptomyces variabilis MTCC 12266

Singh V, Haque S, Kumari V, El-Enshasy HA, Mishra BN, Somvanshi P, et al.

Sci Rep, 2019 04 24;9(1):6482.

PMID: 31019210 DOI: 10.1038/s41598-019-42740-7

Arterial/venous thrombosis is the major cardiovascular disorder accountable for substantial mortality; and the current demand for antithrombotic agents is extensive. Heparinases depolymerize unfractionated heparin (UFH) for the production of low molecular-weight heparins (LMWHs; used as anticoagulants against thrombosis). A microbial strain of Streptomyces sp. showing antithrombotic activity was isolated from the soil sample collected from north India. The strain was characterized by using 16S rRNA homology technique and identified as Streptomyces variabilis MTCC 12266 capable of producing heparinase enzyme. This is the very first communication reporting Streptomyces genus as the producer of heparinase. It was observed that the production of intracellular heparinase was [63.8 U/mg protein (specific activity)] 1.58 folds higher compared to extracellular heparinase [40.28 U/mg protein]. DEAE-Sephadex A-50 column followed by Sepharose-6B column purification of the crude protein resulted 19.18 folds purified heparinase. SDS-PAGE analysis of heparinase resulted an estimated molecular-weight of 42 kDa. It was also found that intracellular heparinase has the ability to depolymerize heparin to generate LMWHs. Further studies related to the mechanistic action, structural details, and genomics involved in heparinase production from Streptomyces variabilis are warranted for large scale production/purification optimization of heparinase for antithrombotic applications.

Matched MeSH terms: Thrombosis; Venous Thrombosis

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