[Biermer's disease and venous thrombosis. Report of two cases].
BACKGROUND
The main issue in venous thrombotic events is their etiology. Several clinical and/or biological data can be helpful in that research. In the two cases we report here, a macrocytic anemia led to the diagnosis of probably acquired hyperhomocysteinemia.


METHODS



METHODS
a 24-year-old man was admitted for severe anemia and a superior vena cava syndrome. Biological data showed megaloblastic anemia and mild features of blood destruction that were explained by a pernicious anemia. Second case: a 35-year-old man had two deep venous thrombotic events in one year (involving the right leg, then the left leg); biological findings showed a macrocytic mild anemia that was diagnosed as a pernicious anemia. In both of the patients, deep venous thrombosis was mainly explained by a hyperhomocysteinemia that was a consequence of vitamin B12 deficiency. The two patients improved under anticoagulant treatment combined with subcutaneous vitamin B12.


CONCLUSIONS
Pernicious anemia can cause acquired hyperhomocysteinemia, which is considered a risk factor for deep venous thrombosis. Thus, the connectivity of these conditions should remain in the practitioner's mind, especially when thrombosis occurs along with a macrocytic anemia.
Kharchafi
A
A
Service de Médecine B, hôpital militaire d'instruction Mohammed V, Rabat, Maroc. azizkharchafi@yahoo.fr
Oualim
Z
Z
Amezyane
T
T
Mahassin
F
F
Ghafir
D
D
Ohayon
V
V
Archane
M I
MI
D000328:Adult; D000752:Anemia, Pernicious / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000209:etiology*; D007279:Injections, Subcutaneous; D008297:Male; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology*; D014805:Vitamin B 12 / Q000627:therapeutic use
D014805:Vitamin B 12