Ishii Hiroki, Morichi Shinichiro, Watanabe Yusuke, Hayashi Kanako, Yamanaka Gaku
Department of Pediatrics and Adolescent Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
BMC Pediatr. 2025 Feb 13;25(1):114. doi: 10.1186/s12887-024-05374-x.
Upper extremity deep venous thrombosis (UEDVT) is a disease caused by angiectopia and hypercoagulation, which result in the superficial vein to become dilatated by the development of collateral circulation. There have been no reports to date of cases of bilateral axillary vein thrombosis developing in the early infant period. Moreover, whether anticoagulant administration is indicated varies among patients.
A 1-month-old boy presented with dilatated superficial veins in the right temporalis, right auricle, whole face, and bilateral upper limbs. Venous dilatation of the right temporalis worsened while crying. He had no notable family history. The patient's heart had a normal structure, and the foramen ovale was patent on transthoracic echocardiography, and closed at 3-months old. Bilateral axillary vein thrombi were displayed on bilateral brachial vein angiography. Anticoagulants were not administered because the patient's systemic circulation developed normally, and our analysis did not detect any abnormal coagulation disorders in the patient. However, the patient suddenly developed right hemiplegia at 6-months old, which naturally resolved without the administration of anticoagulants.
In patients presenting with bilateral UEDVT, the administration of anticoagulants should be considered owing to the possibility of vasculitis and congenital abnormal coagulation disorders.
上肢深静脉血栓形成(UEDVT)是一种由血管扩张和高凝状态引起的疾病,导致浅表静脉因侧支循环的发展而扩张。迄今为止,尚无关于婴儿早期发生双侧腋静脉血栓形成病例的报道。此外,抗凝剂的使用指征在不同患者中有所不同。
一名1个月大的男孩出现右侧颞部、右耳廓、全脸及双侧上肢浅表静脉扩张。右侧颞部静脉扩张在哭闹时加重。他没有明显的家族史。患者心脏结构正常,经胸超声心动图显示卵圆孔未闭,3个月时闭合。双侧肱静脉血管造影显示双侧腋静脉血栓形成。由于患者体循环发育正常,且我们的分析未发现患者有任何异常凝血障碍,因此未给予抗凝剂治疗。然而,患者在6个月大时突然出现右侧偏瘫,未给予抗凝剂治疗后自然缓解。
对于出现双侧上肢深静脉血栓形成的患者,由于存在血管炎和先天性异常凝血障碍的可能性,应考虑给予抗凝剂治疗。