title: Axillary vein thrombosis and congenital dysfibrinogenemia in a commercial pilot: a case report.
abstract: A 34-yr-old male commercial pilot developed a painful swollen right upper arm following an episode of trauma. Venography confirmed the clinical diagnosis of a right axillary deep venous thrombosis. Magnetic resonance imaging suggested the presence of a fibrous tissue band overlying the junction of the right subclavian and innominate veins, potentially creating a thoracic outlet syndrome. A thrombophilia screen revealed an abnormal fibrinogen variant consistent with a diagnosis of congenital dysfibrinogenemia. The pilot was treated with anticoagulant therapy for 4 mo. There were diagnostic difficulties in determining the definitive etiology of the axillary vein thrombosis. Congenital dysfibrinogenemia is a rare condition, which is asymptomatic in the majority, but may manifest with hemorrhage or thrombosis in up to 45% of cases. The clinical management of the pilot and the aeromedical implications of the diagnosis are discussed.
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D001359:Aviation; D001367:Axillary Vein / Q000000981:diagnostic imaging / Q000473:pathology; D020147:Coagulation Protein Disorders / Q000151:congenital* / Q000175:diagnosis; D003937:Diagnosis, Differential; D015241:Fibrinogens, Abnormal; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009784:Occupational Diseases / Q000175:diagnosis*; D010690:Phlebography; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology*
chemical_list: D015241:Fibrinogens, Abnormal