Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Phlegmasia cerulea dolens is a rare form of massive proximal venous thrombosis of the lower extremities associated with a high degree of morbidity, presenting with sudden severe lower extremity pain with edema and cyanosis. Venous gangrene, venous congestion with massive fluid sequestration leading to circulatory collapse, and shock causing death can ensue if not promptly diagnosed and treated. We present a clinical image of a 55-year-old man with newly diagnosed cholangiocarcinoma who presented with worsening left lower extremity pain. We found painful swelling with purple discoloration extending up to the ankle joint. Distal arterial pulses were palpable. Doppler ultrasound revealed extensive thrombosis in all segments of the deep vein bilaterally except the right iliac segment. Anticoagulation with heparin was initiated. The patient underwent an emergency left iliac thrombectomy for salvage of the limb and placement of a prophylactic inferior vena cava filter. The patient's symptoms resolved.
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PMID:Phlegmasia cerulea dolens--a rare, life-threatening condition. 1983 96

Phlegmasia cerulea dolens (PCD) is an aggressive and life-threatening form of venous thrombosis complicated by ischemic necrosis. Massive thrombosis extends to collateral veins resulting in venous congestion with fluid sequestration in the interstitium causing collapse of arterioles, which progresses to ischemia and, if severe, circulatory collapse and shock. The mortality rate for PCD is as high as 40%, especially when gangrene develops. PCD has been associated with acquired thrombophilias, including malignancy and antiphospholipid syndrome (APS). We present a unique case of a patient with PCD refractory to anticoagulant and thrombolytic therapy, whose fulminant course was attributed to concurrent cholangiocarcinoma and antiphospholipid antibodies identified by a positive lupus anticoagulant assay. This case highlights the importance of uncovering precipitating causes of thromboembolism, which may offer prognostic information and may necessitate therapy beyond anticoagulation and thrombolysis to reduce the morbidity of PCD. The current literature on PCD and APS, along with their associations with malignancy, is reviewed.
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PMID:Fulminant phlegmasia cerulea dolens with concurrent cholangiocarcinoma and a lupus anticoagulant: a case report and review of the literature. 2455 60