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CASE REPORTS
NUMBER 1 YEAR 2007
Hyperhomocysteinemia and Type II Protein S Deficiency - Causes of Multiple Arterial Thrombosis
1 2nd Internal Medicine Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

Correspondence to:
Daniela Fodor, 2nd Internal Medicine Clinic, 4 Clinicilor Str., Cluj Napoca, Romania
Email: dfodor@umfcluj.ro
REZUMAT
Hiperhomocisteinemia este recunoscuta ca un factor de risc independent pentru ateroscleroza, dar sunt putine date in literatura privind rolul acesteia in trombozele arteriale acute, fara leziuni vasculare preexistente. Prezentam cazul unei femei de 48 de ani cu antecedente de infarct intestino-mezenteric si rezectie intestinala. Pe parcursul spitalizarii aceasta a prezentat trei episoade de ischemie acuta: doua la nivelul intestinului subtire (rezolvate chirugical) si o tromboza acuta a arterei poplitee drepte (tratament conservator). Nu s-au decelat surse emboligene, nici leziuni aterosclerotice. Determinarile de laborator au stabilit prezenta hiperhomocisteinemiei si a tipului II de deficit de proteina S. Subliniem importanta determinarii homocisteinei serice si a altor factori de risc pentru trombozele arteriale la un pacient cu status trombofilic, mai ales daca acesta este tinar sau trombozele sunt cu localizari neobisnuite.

ABSTRACT
Hyperhomocysteinemia is considered to be an independent risk factor for atherosclerosis, but there is few data regarding its role in acute arterial thrombosis without any previous lesions. We present the case of a 48 years old female with personal history of small bowel infarction and intestinal resection. During the hospitalization she had three acute ischemic episodes: two at small bowel level (surgical resection), and an acute occlusion of the right popliteal artery (medical treatment). There was no embolic source and no atherosclerotic lesions. Laboratory findings showed hyperhomocysteinemia and type II protein S deficiency. We underline the importance of measuring homocysteinemia and other risk factors for arterial thrombosis in a patient with thrombophilic state, especially in a young patient or in thrombosis in unusual place.


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