Trousseau's syndrome in association with cholangiocarcinoma: positive tests for coagulation factors and anticardiolipin antibody.
Thromboembolic events are reported to occur with a high frequency in the setting of malignancy. However, reports on an association between cholangiocarcinoma and pulmonary thromboembolism, thus far, are almost lacking. We present here an unusual case of a 56-yr-old patient presenting cholangiocarcinoma and unexplained pulmonary thromboembolism. The patient had been quite healthy before the diagnosis. Coagulation tests showed elevated levels of fibrinogen, fibrinogen degradation product (FDP), D-dimer, and IgM anticardiolipin antibody (aCL Ab). The thromboemboli were resolved 3 weeks after anticoagulant therapy using low molecular-weight-heparin. Then, follow-up coagulation tests showed a marked decrease to normal in aCL Ab titer as well as the normalization of FDP and D-dimer levels. In this case, we describe pulmonary thromboembolism caused by hypercoagulable state associated with cholangiocarcinoma and speculate that such a thrombotic phenomenon could be regressed by anticoagulant therapy.
Department of Internal Medicine, College of Medicine, WHO Collaborating Center on Viral Hepatitis, The Catholic University of Korea, Seoul, Korea.
Jeong Won
JW
Jang
Chang Dong
CD
Yeo
Jin Dong
JD
Kim
Si Hyun
SH
Bae
Jong Young
JY
Choi
Eun Sun
ES
Jung
Sung Eun
SE
Rha
Jae Young
JY
Byun
Seung Kew
SK
Yoon
D017153:Antibodies, Anticardiolipin / Q000097:blood; D000925:Anticoagulants / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000150:complications*; D001653:Bile Ducts, Intrahepatic; D001779:Blood Coagulation Factors / Q000032:analysis; D018281:Cholangiocarcinoma / Q000150:complications*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D013577:Syndrome; D016896:Treatment Outcome
D017153:Antibodies, Anticardiolipin; D000925:Anticoagulants; D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; D006495:Heparin, Low-Molecular-Weight; C036309:fibrin fragment D; D005340:Fibrinogen