title: [A case of acute pulmonary thromboembolism accompanied by anomalous inferior vena cava with azygous continuation].
abstract: A 38-year-old man with atopic dermatitis presented with right chest pain and dyspnea. Previously, he had received 2mg of betamethasone daily, to prevent rejection of the right transplanted cornea, for 24 days. His body temperature was 37.4 degrees C, peripheral leucocyte count measured 12,000/mm3, and C-reactive protein was 6.3 mg/dl. A computed tomogram of the chest revealed infiltration in the right lower lung field, and he was then treated for pneumonia. The second day he fell down one flight of stairs due to a syncopal attack and received a head injury. At this point his vital blood pressure was 102/55 mmHg, heart rate was 130/min and SpO2 under breathing room air was 76%. These findings indicated possible acute pulmonary thromboembolism. Enhanced computed tomography revealed pulmonary arteries occluded by massive thrombosis and anomalous inferior vena cava with azygous continuation. To decrease the risk of further cerebral bleeding, anti-coagulation therapy was administered with only 24,000 IU/day of heparin. Following treatment, the patient completely recovered. We reported this rare case of acute pulmonary thromboembolism accompanied by anomalous inferior vena cava with azygous continuation.
authors.affiliation: Department of Respiratory and Allergic Medicine, Kinki University School of Medicine.
authors.forename: Sayako
authors.initials: S
authors.lastname: Kitaguchi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Miyara
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ueda
authors.forename: Fumio
authors.initials: F
authors.lastname: Tsuji
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sano
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwanaga
authors.forename: Masato
authors.initials: M
authors.lastname: Muraki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kubo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tohda
mesh_terms: D000208:Acute Disease; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001401:Azygos Vein / Q000002:abnormalities*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000002:abnormalities*
chemical_list: D000925:Anticoagulants; D006493:Heparin