title: Extensive venous thrombosis of the upper extremity in a diabetic patient with a hyperosmolar hyperglycemic state.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Juri
authors.initials: J
authors.lastname: Park
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Kim
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Ji A
authors.initials: JA
authors.lastname: Seo
authors.forename: Sin Gon
authors.initials: SG
authors.lastname: Kim
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Baik
authors.forename: Dong Seop
authors.initials: DS
authors.lastname: Choi
mesh_terms: 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*
chemical_list: D000925:Anticoagulants; D007004:Hypoglycemic Agents; D007328:Insulin