Abdominal vein thrombosis secondary to syphilis in an adolescent

Year 2022, Volume: 47 Issue: 3, 1372 - 1374, 30.09.2022

Ersin Töret , Zeynep Canan Özdemir , Yalçın Kara , Çiğdem Öztunalı , Ozcan Bor

https://doi.org/10.17826/cumj.1123058

Abstract

We present an adolescent with syphilis secondary thrombosis extending from the bilateral renal veins to the inferior vena cava. A 16-year-old male patient presented to the emergency department with severe abdominal and back pain for 12 hours. Abdominal ultrasonography was performed for the differential diagnosis of acute abdomen, and the radiologist reported chronic thrombus occluded the inferior vena cava, the main iliac veins on both sides, and the proximal part of the external iliac veins, starting at the level of the renal veins. It was learned from his clinical history that he had fever every two to three days for about a month. The case, who learned that she had sexual intercourse with a sex worker about two years ago, was screened for sexually transmitted diseases and the western blot test was positive for syphilis. Warfarin was started on the 5th day of heparin treatment and recanalization was observed in the control Doppler USG at the fourth week.

Keywords

childhood, syphilis, thrombosis, warfarin

Supporting Institution

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Thanks

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Bir ergende sifilize ikincil abdominal ven trombozu

Abstract

Bilateral renal venlerden vena cava inferiora uzanan sifilize sekonder trombozu olan bir ergeni sunuyoruz. On altı yaşında erkek hasta, on iki saattir şiddetli karın ve sırt ağrısı ile acil servise başvurdu. Akut karın ayırıcı tanısı için karın ultrasonografisi yapıldı ve radyolog renal venler seviyesinden başlayarak, vena cava inferior, her iki taraftaki ana iliak venler ve eksternal iliyak venlerin proksimal kısmını tıkayan kronik trombüs bildirdi. Klinik öyküsünden yaklaşık bir aydır iki-üç günde bir ateşi olduğu öğrenildi. Yaklaşık iki yıl önce seks işçisi ile cinsel ilişkiye girdiği öğrenilen olgu cinsel yolla bulaşan hastalıklar açısından tarandı ve western blot testi sifiliz için pozitif sonuçlandı. Heparin tedavisinin 5. gününde varfarin başlandı ve dördüncü haftada kontrol doppler USG'de rekanalizasyon izlendi.

Keywords

çocukluk çağı, sifiliz, varfarin

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References

• 1. Hook EW 3rd. Syphilis [published correction appears in Lancet. 2019 Mar 9;393(10175):986]. Lancet. 2017;389(10078):1550-1557.
• 2. Tampa M, Sarbu I, Matei C, Benea V, Georgescu SR. Brief history of syphilis. J Med Life. 2014;7(1):4-10.
• 3. Jadav RS, Goldstein T, Alzyood L, Campana M, Adler V. A Rare Case of an Abdominal Aortic Thrombus Secondary to Syphilitic Aortitis. Cureus. 2020; 12(7): e9397. 4. Monagle P, Cuello CA, Augustine C, et al. American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv. 2018;2(22):3292-3316.
• 5. Kumar R, Kerlin BA. Thrombosis of the Abdominal Veins in Childhood. Front Pediatr. 2017; 5:188.
• 6. Dautaj A, Krasi G, Bushati V, et al. Hereditary thrombophilia. Acta Biomed. 2019 Sep 30;90(10-S):44-46.
• 7. Journeycake JM, Manco-Johnson MJ. Thrombosis during infancy and childhood: what we know and what we do not know?. Hematol Oncol Clin North Am. 2004 Dec;18(6):1315-38, viii-ix.
• 8. Yang JY, Chan AK. Pediatric thrombophilia. Pediatr Clin North Am. 2013;60(6):1443-1462.
• 9. Witmer C, Raffini L. Treatment of venous thromboembolism in pediatric patients. Blood. 2020;135(5):335-343.
• 10. Chalmers EA. Heritable thrombophilia and childhood thrombosis. Blood Rev. 2001;15(4):181-189.
• 11. Heller C, Schobess R, Kurnik K, et al. Abdominal venous thrombosis in neonates and infants: role of prothrombotic risk factors- a multicentre case-control study. For the Childhood Thrombophilia Study Group. Br J Haematol. 2000;111(2):534-539.
• 12. US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, Grossman DC, et al. Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315 (21): 2321-2327.