Roberge Guillaume, Samson Carine, Le Gal Grégoire, Calabrino Anthony
Centre d'Excellence des Maladies Vasculaires, Centre Hospitalier Universitaire de Québec, Université Laval, Hôpital Saint-François d'Assise, Québec, Canada.
MaClinique Médicale Lebourgneuf, Québec, Canada.
TH Open. 2023 Apr 20;7(2):e94-e96. doi: 10.1055/s-0043-57225. eCollection 2023 Apr.
Intermittent fasting is becoming more popular as health benefits are described in recent literature. Various forms of fasting exist, one of them involving a zero-calorie diet and drinking only water. However, the safety of water-only fasting is still not well established. We report a case of a man who developed a lower limb deep vein thrombosis at the end of a 2-week water-only fasting and characterized by an initial period of 5 days of no food and no water intake. We reviewed literature regarding potential links between fasting and venous thromboembolism (VTE). We believe that fasting can induce important dehydration, leading to hypercoagulability and then contribute to the development of a venous thrombosis. The patient was treated with apixaban for 3 months as is recommended in patients with a provoked event caused by a transient risk factor. No thrombotic recurrence was observed during the 6-month follow-up. The public needs to be aware of the potential life-threatening complications associated with important dehydration in the setting of medically unsupervised fasting, and these might include VTE. Whether a VTE with dehydration as the only identified risk factor should be approached as a low recurrence risk situation or not still needs to be clarified.
随着近期文献中描述了间歇性禁食的健康益处，它正变得越来越流行。存在各种形式的禁食，其中一种是零热量饮食且只饮水。然而，仅饮水禁食的安全性仍未得到充分证实。我们报告了一例男性患者，他在为期2周的仅饮水禁食结束时发生了下肢深静脉血栓形成，其特点是最初5天既不进食也不饮水。我们回顾了关于禁食与静脉血栓栓塞（VTE）之间潜在联系的文献。我们认为禁食可导致严重脱水，进而引起血液高凝状态，从而促使静脉血栓形成。该患者按照由短暂风险因素引发的事件的推荐治疗方案，接受了3个月的阿哌沙班治疗。在6个月的随访期间未观察到血栓复发。公众需要意识到在无医学监督的禁食情况下，严重脱水可能会带来危及生命的并发症，其中可能包括VTE。对于仅将脱水作为唯一确定风险因素的VTE是否应被视为低复发风险情况仍有待明确。
