title: A case of lower extremity venous thrombosis in the pediatric emergency department: associations with May-Thurner syndrome and isotretinoin use.
abstract: Unilateral calf swelling and pain is not a common complaint in the pediatric emergency department. We present a case of a 17-year-old adolescent boy with no past medical history who presented with left leg swelling and pain while taking prednisone and isotretinoin. He was found to have an extensive occlusive thrombus throughout the deep venous system in his left leg. He was later diagnosed with May-Thurner syndrome, an anatomic variant in which the right iliac artery compresses the left iliac vein. We review the differential diagnosis, diagnostic workup, and initial ED management of deep venous thrombosis and provide a brief discussion of May-Thurner syndrome and the association of isotretinoin and vascular thrombi.
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Whitman
authors.forename: David M
authors.initials: DM
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D017130:Angioplasty / Q000295:instrumentation / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007083:Iliac Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D007084:Iliac Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging; D015474:Isotretinoin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000000981:diagnostic imaging; D010690:Phlebography; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D018570:Risk Assessment; D015607:Stents; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects; D013577:Syndrome; D054079:Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery
chemical_list: D000925:Anticoagulants; D013256:Steroids; D006493:Heparin; D015474:Isotretinoin