Department of Internal Medicine, Faculty of Medicine, Airlangga University, Dr. Soetomo Hospital, Surabaya, Indonesia.
Nephrology Division, Department of Internal Medicine, Faculty of Medicine, Airlangga University, Dr. Soetomo Hospital, Surabaya, Indonesia.
Pan Afr Med J. 2022 May 11;42:25. doi: 10.11604/pamj.2022.42.25.34452. eCollection 2022.
A male patient aged 50 years, presented with a swelling in the right leg which had occurred five days before hospital admission. This was associated with pain in the swollen leg. The patient had a history of femoral double lumen catheter (DLC) insertion for hemodialysis. On physical examination, Wong Baker's scale was 3, Wells' score was 3, and the patient had edematous, red, and warm right lower extremity. Laboratory results showed anemia (Hb 11.4 g/dl), leukocytosis (27.99 x 10/ul), increased blood urea nitrogen (BUN) (60 mg/dl), increased serum creatinine (9.93 mg/dl), hyperkalemia (6 mmol/l), urine leukocytes +3; 15-20/hpf. Lower extremity ultrasound revealed diffuse deep vein thrombosis (DVT). After the diagnosis of DVT, the patient was treated with fondaparinux injection and warfarin as an anticoagulant for six days. Our results show that treatment was effective in reducing swelling and pain in the right leg, that disappeared after a three months´ treatment.
一位 50 岁男性患者,五天前出现右腿肿胀伴疼痛,有股动脉双腔导管(DLC)置入史,用于血液透析。体格检查显示,Wong Baker 量表评分为 3 分,Wells 评分为 3 分,右下肢水肿、红肿、皮温高。实验室结果显示贫血(Hb 11.4 g/dl)、白细胞增多(27.99 x 10/ul)、血尿素氮(BUN)升高(60 mg/dl)、血清肌酐升高(9.93 mg/dl)、高钾血症(6 mmol/l)、尿白细胞阳性(+3);15-20/高倍视野。下肢超声显示弥漫性深静脉血栓形成(DVT)。诊断为 DVT 后,患者接受了那屈肝素钙注射和华法林抗凝治疗六天。我们的结果表明,治疗有效,右下肢肿胀和疼痛减轻,三个月治疗后消失。