Vaskulárna medicína 2/2014

Young patient with recurrent deep vein thrombosis – causes and consequences

The article describes a case report of a complicated course of venous thromboembolic disease. A young man was hospitalized in our department in 2003 with suspected recurrence of deep vein thrombosis. Ultrasonograpy found multiple thrombotic changes in the deep veins of both legs, probably of various duration. X-ray venography revealed chronic venous occlusion in pelvic veins bilaterally. We started administration of low-molecular-weight heparin with transition to warfarin. However, drug-induced liver damage occurred as a consequence of warfarin use. Moreover, we confirmed a strong combined hypercoagulable state. We recommended a long-term anticoagulation with low-molecular-weight heparin. During follow-up, the patient has been several times treated for leg ulcer, associated with advanced postthrombotic syndrome. Since 2012, he has been on long-term oral anticoagulation with rivaroxaban.

Keywords: deep vein thrombosis, hypercoagulable state, anticoagulation, postthrombotic syndrome.