Darawshy Fares, Kalish Yosef, Hendi Issam, Abu Rmelieh Ayman, Khoury Tawfik
Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Case Rep Hematol. 2017;2017:7290945. doi: 10.1155/2017/7290945. Epub 2017 Sep 25.
Deep vein thrombosis (DVT) is a rare disease in patients with hemophilia A. We report a case of 22-year-old male with severe hemophilia A who presented to the emergency room with 5-day history of right arm pain that was attributed initially to bleeding event. In the absence of external signs of bleeding or hematoma and normal hemoglobin level, we suspected an underlying DVT. Doppler ultrasonography of the right upper limb revealed thrombosis of the subclavian vein and this was confirmed by CT venography. The d-dimer level was normal and investigations for prothrombotic state revealed heterozygosity for prothrombin G20210A mutation. Treatment with factor VIII and low molecular weight heparin led to successful resolution and marked improvement of his clinical condition.
在甲型血友病患者中，深静脉血栓形成（DVT）是一种罕见疾病。我们报告一例22岁重度甲型血友病男性患者，该患者因右臂疼痛5天就诊于急诊室，最初认为是出血事件所致。在没有出血或血肿的外部体征且血红蛋白水平正常的情况下，我们怀疑存在潜在的深静脉血栓形成。右上肢多普勒超声检查显示锁骨下静脉血栓形成，CT静脉造影证实了这一诊断。D-二聚体水平正常，对血栓前状态的检查显示凝血酶原G20210A突变杂合子。使用凝血因子VIII和低分子量肝素治疗后，患者临床症状成功缓解且显著改善。
