Simultaneous pulmonary thromboembolism and superior mesenteric venous thrombosis associated with hyperhomocysteinemia secondary to pernicious anemia-induced vitamin B12 deficiency

Oliveira, Leonardo Rodrigues de; Fonseca, Jordana Rafaella

doi:10.1016/j.htct.2017.11.004

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…Ten cases of systemic venous thrombosis caused by autoimmune gastritis have been previously reported (Table 1). 9–14 Among them, one case developed superior sagittal sinus thrombosis resulting in a poor outcome due to cerebral hemorrhage. 9 All 10 patients were treated with anticoagulants (warfarin, heparin, small molecule weight heparin, and enoxaparin) and 1–5 mg of vitamin B12 daily by mouth without recurrence of CVT (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Cerebral venous thrombosis associated with hyperhomocysteinemia and iron-deficiency anemia induced by autoimmune gastritis: A case report and literature review

et al. 2022

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Cerebral venous thrombosis (CVT) is a rare disease, occurring in 0.5%–1% of all patients with strokes. Systemic and hereditary diseases and traumas are potential causes of CVT. We report a case of CVT and systemic thromboembolism complicated with hyperhomocysteinemia and iron-deficiency anemia caused by autoimmune gastritis. A 47-year-old female patient was admitted to the emergency department due to difficulty in movement, impaired consciousness, and urinary incontinence. Brain computed tomography (CT) and magnetic resonance imaging (MRI) showed bilateral thalamic edema associated with venous sinus thrombosis and embolic cerebral infarction in the deep white matter of the bilateral cerebral hemispheres. In addition, contrast enhanced whole-trunk CT scan showed deep femoral thrombosis and pulmonary artery embolism. She had no medical history of diseases or drug use that may cause thrombosis. Blood test results revealed iron-deficiency anemia and hyperhomocysteinemia, which were determined to be the cause of systemic thromboembolism. The patient tested positive for intrinsic factor antibodies. Moreover, the patient was diagnosed with autoimmune gastritis by gastrointestinal endoscopy. Therapies including anticoagulant and replacement with iron and vitamin B12 were administered. The patient was discharged from the hospital without neurological deficits. A favorable clinical course was achieved with anticoagulant administration and replacement therapy with iron and vitamin B12 for cerebral arteriovenous embolism that developed due to autoimmune gastritis.

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Section: Discussionmentioning

confidence: 99%

Cerebral venous thrombosis associated with hyperhomocysteinemia and iron-deficiency anemia induced by autoimmune gastritis: A case report and literature review

et al. 2022

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“…It increases homocysteine plasma levels, a highly known risk factor for venous embolism. Homocysteine interferes with activation of factor Va, by increasing levels of protein C, apart from increasing the expression of tisular factor and suppressing sulfate heparin, an endogenous anticoagulant [1] , [2] , [3] .…”

Section: Discussionmentioning

confidence: 99%

“…According to the literature, it can be easily treated if diagnosed promptly. The most common cause of B12 deficiency is pernicious anemia, but in this case was ruled out, considering probably other factors related to its deficiency [1] , [4] , [5] , [6] .…”

Section: Discussionmentioning

confidence: 99%

Pulmonary embolism and megaloblastic anemia: is there a link? A case report an literature review

Raymundo-Martínez

Gopar‐Nieto

Carazo-Vargas

et al. 2018

Radiology Case Reports

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Many factors have been associated with venous thromboembolism. Among them, vitamin B12 deficiency can produce elevated homocysteine levels, which is a risk factor for venous embolism, since the latter interferes with the activation of Va coagulation factor by activation of C protein.We present a case of a patient with metabolic syndrome with apparently unprovoked pulmonary embolism. After careful evaluation, megaloblastic anemia was detected. Even though the patient had biochemistry findings of hemolysis and blood smear did not showed fragmented erythrocytes, which is consistent with pseudo-microangiopathic hemolytic anemia.

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“…Among several observational studies there is a general agreement that possible risk factors for placenta-mediated diseases, like spontaneous abortion, pre-eclampsia and placental abruption can be due to deficiency of folate, hyperhomocysteinaemia and homozygosity for the methylenetetrahydrofolate reductase thermolabile variant. One of the less well defined as an important factor was vitamin B12 deficiency (22,23). The association between preeclampsia and thrombophilia is also controversial.…”

Section: Influence Of Thrombophilia On Detrimental Pregnancy Outcomesmentioning

confidence: 99%

Thrombophilia and Pregnancy

Loncar

Мilоvаnоvić

2022

Serbian Journal of Experimental and Clinical Research

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Leading cause of death in pregnant women still remains venous thromboembolism, with an incidence of 1.4 to 4.9 per 100,000 pregnancies. A special group of inherited and acquired coagulation disorders associated with a susceptibility to thrombosis is thrombophilia. Physiological changes during the pregnancy also contribute to the occurrence thromboembolic diseases (VTE) in pregnancy. Total rate of venous thromboembolism is 100 per 100,000 pregnancies and 200 per 100,000 births. Etiopathogenesis of obstetric complications in thrombophilia is not clearly defined, which is one of the reasons for the occasional failure of therapy. In pregnancies with hereditary thrombophilia the oxidative stress is considered to be a cause of complications, similar to preeclampsia. Based on the findings so far, additional research should clarify questions regarding the anticoagulants role in pregnancy loss prevention. In this paper, we analyze the effect of the screening on pregnancy outcomes, consider the justification for the use of anticoagulation therapy in difficult situations, discuss about previous knowledge in the field and argue the use of new specific protocols. In short, we address the justification for prescribing anticoagulants and evaluation of their effect within thrombophilia therapeutic strategies.

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Simultaneous pulmonary thromboembolism and superior mesenteric venous thrombosis associated with hyperhomocysteinemia secondary to pernicious anemia-induced vitamin B12 deficiency

Cited by 6 publications

References 15 publications

Cerebral venous thrombosis associated with hyperhomocysteinemia and iron-deficiency anemia induced by autoimmune gastritis: A case report and literature review

Cerebral venous thrombosis associated with hyperhomocysteinemia and iron-deficiency anemia induced by autoimmune gastritis: A case report and literature review

Pulmonary embolism and megaloblastic anemia: is there a link? A case report an literature review

Thrombophilia and Pregnancy

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