Extensive venous thrombosis of the upper extremity in a diabetic patient with a hyperosmolar hyperglycemic state.
We report a case of extensive venous thrombosis of the upper extremity in a patient with a hyperosmolar hyperglycemic state (HHS). Thrombosis of the upper extremities is generally found in 4% of cases with deep venous thrombosis. Extensive, symptomatic venous thrombosis of the upper extremity, as seen in this patient, is rare except with catheter-related thrombosis. Recent studies have supported the safety and efficacy of catheter-directed thrombolysis in patients with no contraindication to thrombolytic therapy, and have recommended early catheter-directed thrombolysis. Therefore, our patient was treated with early catheter-directed thrombolysis followed by anticoagulation.
Park
Juri
J
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Kim
Dong Jin
DJ
Kim
Hee Young
HY
Seo
Ji A
JA
Kim
Sin Gon
SG
Baik
Sei Hyun
SH
Choi
Dong Seop
DS
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001367:Axillary Vein; D016121:Brachiocephalic Veins; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000150:complications* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D010690:Phlebography; D013350:Subclavian Vein; D015912:Thrombolytic Therapy / Q000379:methods; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D000925:Anticoagulants; D007004:Hypoglycemic Agents; D007328:Insulin