Hypercoagulability in a patient with chronic chyluria, proteinuria and hypoalbuminaemia.
We describe the case of a young man with prolonged and severe chyluria from a previous parasitic infection. He presented with an acute myocardial infarction most likely secondary to increased clotting tendency. He had a spontaneously formed blood clot in his left anterior descending coronary artery. In the setting of hypo-albuminemia (which has occurred because of obligate losses of protein from lymphuria), he has increased production of factor VIII levels and increased clotting tendency. In addition, because of obligate and unregulated fluid losses he has chronic dehydration, miscrovascular ischemia and secondary polycythemia. This polycythemia further increases his risk of hypercoagulability.
Golestaneh
Ladan
L
Department of Medicine, Montefiore Medical Center, Bronx, NY, USA. lgolesta@montefiore.org
Karam
Sabine
S
Lawrence
Janis
J
Yang
Sara
S
Greenberg
Mark
M
D000328:Adult; D002908:Chronic Disease; D002913:Chyle; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications*; D008297:Male; D011507:Proteinuria / Q000150:complications*; D019851:Thrombophilia / Q000209:etiology*; D014556:Urine