Unusual presentation of a sarcoid patient: multiple arterial and venous thrombosis with chest lymphadenopathy.
We depict a case of a 32 year old Mediterranean man, presenting with pulmonary embolism, and diffuse arterial thrombosis of the lower extremities. CT angiography revealed bilateral pulmonary artery occlusions and a mediastinal lymphadenopathy. Duplex Ultrasound of the lower extremities showed no deep venous thrombosis, but occluded popliteal arteries bilaterally with extension to the right distal superficial femoral artery. Mediastinoscopy with hilar lymph node biopsy showed noncaseating granulomas consistent with sarcoidosis. Thrombophilia profile revealed factor II, MTHFR, and factor XIII gene mutations with markedly elevated homocysteine level of 139 mumol/l. This is an atypical rare case of sarcoidosis presenting with pulmonary embolism and multiple arterial thrombosis.
Rebeiz
T J
TJ
American University of Beirut Medical School, Beirut, Lebanon.
Mahfouz
R
R
Taher
A
A
Charafeddine
Kh
Kh
Kanj
N
N
D000328:Adult; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D011655:Pulmonary Embolism / Q000209:etiology; D017565:Sarcoidosis, Pulmonary / Q000150:complications / Q000175:diagnosis*; D020246:Venous Thrombosis / Q000209:etiology
Blood. 1999 Feb 1;93(3):906-8
9920839
Blood. 2002 Aug 1;100(3):743-54
12130481
South Med J. 2006 Sep;99(9):998-9
17004536
Haematologica. 1997 Mar-Apr;82(2):211-9
9175329
Thorax. 2003 Jun;58(6):552
12775877
J Thromb Haemost. 2005 Aug;3(8):1646-54
16102030
Blood. 1996 Nov 15;88(10):3698-703
8916933
Thromb Haemost. 1997 Jul;78(1):523-6
9198208
Proc (Bayl Univ Med Cent). 2001 Jan;14(1):8-12
16369580