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低分子量肝素在作为溃疡性结肠炎罕见并发症出现的小儿脑静脉窦血栓形成中的光明前景。

The Promising Future of Low-Molecular-Weight Heparin in Pediatric Cerebral Venous Sinus Thrombosis Occurring as a Rare Complication of Ulcerative Colitis.

作者信息

Yaqoob Sadia, Jaiswal Vikash, Ruxmohan Samir, Shakeel Hassan, Patel Srushti

机构信息

Internal Medicine, Jinnah Medical and Dental College, Karachi, PAK.

Internal Medicine, AMA School of Medicine, Makati, PHL.

出版信息

Cureus. 2021 Aug 13;13(8):e17168. doi: 10.7759/cureus.17168. eCollection 2021 Aug.

Abstract

Pediatric cerebral venous sinus thrombosis (CVST) is a rare complication of ulcerative colitis. Ulcerative colitis is a form of inflammatory bowel disease which accentuates hypercoagulation, thereby leading to thrombosis. Herein, we report a case of a 10-year-old girl who presented with chief complaints of headache, confusion, and new-onset seizure activity for one month as progressively worsening sequelae of ulcerative colitis. Her magnetic resonance venogram confirmed thrombosis in the right transverse, sigmoid, and superior sagittal sinus. The acute ulcerative colitis flare was managed with a short course of steroids and anti-inflammatory monoclonal antibody, and CVST got improved with low-molecular-weight heparin (LMWH). Our study emphasizes the emergence of fatal complications of ulcerative colitis in the pediatric population. It also endorses the pivotal role of thromboprophylaxis with LMWH in pediatric CVST patients. Nevertheless, further studies are required to standardize the use of LMWH in clinical practice.

摘要

小儿脑静脉窦血栓形成(CVST)是溃疡性结肠炎的一种罕见并发症。溃疡性结肠炎是炎症性肠病的一种形式,会加剧高凝状态,从而导致血栓形成。在此,我们报告一例10岁女孩,她以头痛、意识模糊和新发癫痫发作活动为主诉,这些症状作为溃疡性结肠炎逐渐恶化的后遗症已持续一个月。她的磁共振静脉造影证实右侧横窦、乙状窦和上矢状窦存在血栓形成。急性溃疡性结肠炎发作通过短期使用类固醇和抗炎单克隆抗体进行治疗,CVST通过低分子量肝素(LMWH)得到改善。我们的研究强调了溃疡性结肠炎在儿科人群中出现致命并发症的情况。它还认可了LMWH在小儿CVST患者中进行血栓预防的关键作用。然而,需要进一步研究以规范LMWH在临床实践中的使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a83/8437157/bc748a9df58f/cureus-0013-00000017168-i01.jpg

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