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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several clinical conditions, such as deep vein thrombosis, cerebral infarct, pulmonary infarct, skin ulcers, renal failure, and habitual abortion, are thought to be associated with the antiphospholipid syndrome. The authors describe a 32-year-old woman who had characteristics of the antiphospholipid syndrome including increased immunoglobulin G-cardiolipin antibody titers, iliofemoral vein thrombosis, pulmonary embolism, headache, visual disturbances, and habitual abortion. During hospitalization, she suddenly experienced right-sided weakness. A Tc-99m HMPAO brain scan showed the probability of a transient ischemic attack in the left frontotemporal cortex.
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PMID:Iliofemoral vein thrombosis and pulmonary embolism associated with a transient ischemic attack in a patient with antiphospholipid syndrome. 1113 72

We encountered 16 cases of venous thromboembolism (VTE) in women during pregnancy and/or puerperium over the past 15 years at our perinatal center, representing 0.14% of all patients who delivered babies. The present study was undertaken to analyze the risk factors, clinical course and outcomes in these 16 cases. The ages of the patients varied from 29 to 39 years. Four women had pulmonary embolism (PE), 3 of which after caesarean section (C/S) at 35 to 40 weeks, and one case after ovarian cystectomy at 13 weeks of gestation. Twelve cases had deep venous thrombosis (DVT), 4 of which during pregnancy, and the remaining 8 cases after C/S. Four patients who had DVT during a normal course of pregnancy had severe thrombophilia: antiphospholipid antibody syndrome, a history of thrombosis and antithrombin (AT) deficiency. They were treated with heparin with or without AT and had healthy babies via successful vaginal deliveries. The common risk factors in 3 cases of PE with C/S was prolonged bed rest due to threatened premature delivery with total placenta previa, uterine myoma and Ehlers-Danlos syndrome. Other risk factors were massive bleeding, and positive lupus anticoagulant. However, the case of the ovarian cystectomy had only one risk factor, which was obesity. This patient died but the remaining patients recovered with treatment. Because of the low incidence of thrombosis in the Japanese population, prophylactic anticoagulant therapy has not routinely been given to patients undergoing obstetrical operations. However, proper management including prophylactic anticoagulant therapy might be considered for risk patients, depending on the risk factors.
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PMID:Clinical study of venous thromboembolism during pregnancy and puerperium. 1137 69

The presence of antiphospholipid antibodies is associated with arterial and venous thrombosis. A 14-year-old girl, with systemic lupus erythematosus (SLE), developed headache and cough and was found to have intracranial venous sinus thrombosis with secondary pulmonary embolism associated with antiphospholipid syndrome. Clinical and radiological improvement occurred with anticoagulation therapy. Because SLE is commonly associated with antiphospholipid antibodies, thromboembolic events should be considered in the differential diagnosis of both cough and headache in children with SLE.
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PMID:Intracranial venous thrombosis and pulmonary embolism with antiphospholipid syndrome in systemic lupus erythematosus. 1153 66

Venous thrombosis, whose main clinical presentations include deep vein thrombosis and pulmonary embolism, represents a major health problem worldwide. Numerous conditions are known to predispose to venous thrombosis and these conditions are commonly referred to as risk indicators or risk factors. Generally accepted or "classically" acquired risk factors for venous thromboembolism include advanced age, prolonged immobilisation, surgery, fractures, use of oral contraceptives and hormone replacement therapy, pregnancy, puerperium, cancer and antiphospholipid syndrome. In addition to these well-established risk factors for venous thrombosis, several lines of evidence that have emerged over the past few decades indicate a role of novel genetic risk factors, mainly related to the haemostatic system, in influencing thrombotic risk. The most significant breakthrough has been the confirmation of the concept that inherited hypercoagulable conditions are present in a large proportion of patients with venous thromboembolic disease. These include mutations in the genes that encode antithrombin, protein C and protein S, and the factor V Leiden and factor II G20210 A mutations. Moreover, plasmatic risk indicators, such as hyperhomocysteinemia and elevated concentrations of factors II, VIII, IX, XI and fibrinogen, have also been documented. This extensive list of genetic and acquired factors serves to illustrate that a single cause of venous thrombosis does not exist and that this condition should be considered as a complex or multifactorial trait. Complex traits can be understood by assuming an interaction between different mutations in candidate susceptibility genes. The risk that is associated with each genetic defect may be relatively low in isolation but the simultaneous presence of several mutations may dramatically increase disease susceptibility. Moreover, environmental factors may interact with one or more genetic variations to add further to the risk. The analysis of genetic risk factors and plasmatic factors, together with private life style and environmental factors, has contributed significantly to our understanding of the genetic predisposition to venous thrombosis.
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PMID:Genetic risk factors of venous thrombosis. 1170 18

A 62-year-old woman with a history of pulmonary embolism and primary antiphospholipid syndrome (PAPS) with positivity for lupus anticoagulant was admitted to hospital with shortness of breath. A filter had been implanted in her inferior vena cava (IVC) 5 years previously. Emergency echocardiography revealed a lobulated, mobile echogenic mass on the tricuspid valve, and on pulmonary perfusion scintigraphy several apparently new defects were noted. Fibrinolytic therapy improved her symptoms and the pulmonary perfusion, then intravenous heparinization was continued for a further week. Repeat echocardiography performed on the 7th day of the admission showed complete disappearance of the mass, which was retrospectively diagnosed as a thrombus based on its resolution with fibrinolytic and anticoagulant therapies.
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PMID:Thrombus on the tricuspid valve in a patient with primary antiphospholipid syndrome after implantation of an inferior vena cave filter. 1195 63

Dermatomyositis and antiphospholipid syndrome are rare diseases that can be associated pulmonary damage. We report a case of anti-phospholipid syndrome that presented with bilateral pulmonary embolism and subsequently developed pulmonary infiltrates in association with the characteristic muscular and cutaneous features of dermatomyositis. Histological examination of trans-bronchial biopsies revealed bronchiolitis obliterans organizing pneumonia.
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PMID:[Bronchiolitis obliterans organizing pneumonia associated with dermatomyositis and antiphospholipid syndrome]. 1204 Mar 26

Antiphospholipid antibody syndrome is an acquired autoimmune disorder characterized by vascular thrombosis and/or recurrent pregnancy losses along with laboratory evidence of antiphospholipid antibodies. Anticoagulation rather than immunosuppression is the mainstay of treatment. Despite the effectiveness of oral anticoagulation for the prevention of recurrent thromboembolic episodes, thrombotic complications in the setting of apparently therapeutic oral anticoagulation have been observed; this may at times be due to difficulties in maintaining a consistently therapeutic level of anticoagulation. Low-molecular-weight heparin has been a useful alternative for long-term anticoagulation when there is difficulty in managing oral anticoagulant therapy and has the advantage of a consistent anticoagulant effect. In this report, we describe a woman with primary antiphospholipid antibody syndrome who developed extensive pulmonary embolism despite receiving a proven therapeutic dosage of low molecular weight heparin.
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PMID:Low-molecular weight heparin: treatment failure in a patient with primary antiphospholipid antibody syndrome. 1244 50

Patients with malignancy often present with a variety of coagulation abnormalities which may ultimately lead to recurrent arterial and venous thromboses. Recently the presence of antiphospholipid antibodies in cancer patients has been proposed as one of the potential mechanisms promoting hypercoagulability. Here we report two consecutive patients with localized tumors, one suffering from breast cancer and another presenting with colorectal cancer, who experienced dramatic exacerbation of the antiphospholipid antibody syndrome (APAS) within 4 weeks after surgery. In the first patient who had also received one course of adjuvant chemotherapy, major ischemic stroke and recurrent venous thromboembolism were paralleled by the development of ulcerative livedoid vasculitis and pancytopenia, constituting the diagnosis of systemic lupus erythematosus with secondary APAS. In the second patient, progressive thrombotic occlusion of the superior and inferior vena cava was associated with bilateral pulmonary embolism, acute renal failure, and disabling soft tissue edema. Although not fulfilling the classic criteria of "catastrophic" APAS, the clinical features were life threatening and appeared to be refractory to oral anticoagulation with phenprocoumon. In addition, a diagnosis of Trousseau's syndrome was unlikely due to missing evidence of gross metastatic disease. Besides a suggested treatment strategy comprising high doses of low-molecular-weight heparin, potential pathogenic mechanisms are discussed in consideration of a recently proposed "thrombotic storm," which may cause multiple thromboses after an initial provocation in patients with known hypercoagulability.
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PMID:Exacerbation of antiphospholipid antibody syndrome after treatment of localized cancer: a report of two cases. 1248 70

Antiphospholipid syndrome is characterized by venous and arterial thrombosis. Antiphospholipid antibodies are essential to making the diagnosis. It may be a primary disorder or it may be secondary to a connective tissue disorder. Cardiac manifestations of this syndrome include both thrombotic and degenerative valvular disease. Systemic or pulmonary embolism, as well as intravascular thrombosis, is a significant cause of morbidity and mortality. We present a case of renal infarction in a woman with polymyalgia rheumatica and a positive test for antiphospholipid antibody.
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PMID:Antiphospholipid syndrome with renal artery embolism: case report. 1255 53

Pulmonary embolism (PE) is a rare but life-threatening condition, which needs emergent treatment in children. Though anticoagulation is the standard treatment for PE, recent studies revealed intrapulmonary thrombolytic therapy may produce more rapid clot lysis and less systemic complications in adult patients. We reported a 10-year-old girl who had diffused multiple pulmonary emboli due to primary antiphospholipid syndrome. The thrombi persisted in spite of intravenous heparin infusion for 3 days, which resolved quickly after intrapulmonary streptokinase infusion for 12 hours.
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PMID:Intrapulmonary thrombolytic therapy in a child with acute pulmonary embolism due to primary antiphospholipid syndrome. 1263 91


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