Pulmonary embolism in a patient with pernicious anemia and hyperhomocysteinemia.
We report the case of a 60-year-old woman with a history of ataxia who sought evaluation after a syncopal episode. A diagnostic workup revealed pulmonary emboli, pernicious anemia (PA), hyperhomocysteinemia, and a G20210A prothrombin gene mutation. She was successfully treated with homocysteine-lowering therapy, including high doses of oral cobalamin. She also received oral anticoagulation for 6 months. At 1 year of follow-up, no further thrombotic episodes had occurred. Our report highlights the thrombotic risk of hyperhomocysteinemia secondary to PA in a patient with the G20210A prothrombin gene mutation.
Caldera
Angel
A
Department of Medicine, Albert Einstein Medical Center, 5401 Old York Road, Philadelphia, PA 19141, USA. calderaa@einstein.edu
Mora
Jorge
J
Kotler
Morris
M
Eiger
Glenn
G
D000284:Administration, Oral; D000752:Anemia, Pernicious / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000925:Anticoagulants / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018570:Risk Assessment; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000008:administration & dosage
D000925:Anticoagulants; D014805:Vitamin B 12