Effort Thrombosis (Paget-Schroetter Syndrome) in a 16-Year-Old Male

Abstract

Patient: Male, 16Final Diagnosis: Effort thrombosis (Paget-Schroetter Sydnrome)Symptoms: Swollen armsMedication: —Clinical Procedure: —Specialty: Metabolic Disorders and DiabeticsObjective:Rare diseaseBackground:Thrombotic events in otherwise healthy pediatric patients are rare. In patients presenting with limb swelling, thrombosis must be considered in the differential diagnosis. In pediatric patients with thrombosis, there has been wide variability in the rates of associated thrombophilia. Many pediatric patients may instead have other contributors such as venous catheters or physical activity.Case Report:We present a case of bilateral upper extremity deep venous thrombi in a previously healthy 16-year-old male. The patient presented with swelling and pain in both arms after several days of weight-bearing exercise. Following emergency department evaluation with ultrasound and laboratory testing, the patient was diagnosed with effort thrombosis – also known as Paget-Schroetter syndrome – and rhabdomyolysis.Conclusions:This case of Paget-Schroetter syndrome is distinguished by elevation in creatine kinase and transaminases. While these findings can be due to physical exertion and effort, effort thrombosis is not classically associated with laboratory abnormalities except an elevated D-dimer. The significance of these laboratory test result abnormalities remains unclear. Given the rarity of effort thrombosis, further epidemiological study is warranted to determine if these laboratory findings are seen in other cases, and, if so, what implications they may have for management and prognosis.

Spontaneous bilateral subclavian vein thrombosis in a 40-year-old man

“…We found only one case report that discussed elevated transaminase level with primary UEDVT. [ 16 ] Further study is needed.…”

Paget-Schroetter Syndrome Resulting from Thoracic Outlet Syndrome and KAATSU Training

“…Thus, PSS is known as “effort thrombosis”. Previous reports have shown that the training of the upper limbs by methods such as performing weight-bearing exercises or push-ups can cause PSS ( 11 , 12 ). In the present case, the costoclavicular space became narrow when the patient elevated her upper limbs on follow-up chest CT, and the blood flow signals were nearly interrupted in the left subclavian vein when she elevated her left upper limb.…”

Catheter-Directed Thrombolysis via Small Saphenous Veins for Treating Acute Deep Venous Thrombosis

“…Deep venous thrombosis (DVT), which occurs primarily in the lower extremities, is prevalent in modern society. It is caused by the abnormal coagulation of the blood in deep veins in the lower extremities due to various factors, such as stasis, hypercoagulability, and endothelial injury [ 1 ]. It can result into acute pulmonary embolism (PE) and long-term complications, such as post-thrombosis syndrome (PTS).…”