Wheelchair economy class syndrome in amyotrophic lateral sclerosis.
A wheelchair-bound 61-year-old diabetic man with amyotrophic lateral sclerosis (ALS) developed sudden respiratory failure. Specific findings for hypoxemia and hypocapnia were incompatible with type II respiratory failure seen in the terminal stages of ALS. 'Economy class syndrome' was diagnosed, with massive thrombosis in the pulmonary arteries and deep vein thrombosis. This case offers a warning for long-term wheelchair users, particularly hypoxemic ALS patients, regarding the risks of treatable pulmonary thromboembolism.
Division of Neurology, The First Department of Internal Medicine, Osaka Medical College, Daigaku-machi 2-7, Takatsukishi, Osaka 569-8686, Japan. in1110@poh.osaka-med.ac.jp
Fumiharu
F
Kimura
Simon
S
Ishida
Daisuke
D
Furutama
Yuuji
Y
Hirata
Toshihiko
T
Sato
Takashi
T
Hosokawa
Toshiaki
T
Hanafusa
D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology*; D003920:Diabetes Mellitus; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein / Q000473:pathology; D011655:Pulmonary Embolism / Q000209:etiology / Q000473:pathology; D016414:Resuscitation Orders; D020246:Venous Thrombosis / Q000209:etiology / Q000473:pathology; D014910:Wheelchairs / Q000009:adverse effects*