title: Painful congestion of the lower limbs and recurrent fever.
abstract: We describe a 45-year-old patient with massive pain and congestion in the lower limbs. In addition, he daily presented fever up to 39.5°C (103.1°F) without any infectious focus for 8 days. A formerly unknown vena cava atresia with severe bilateral deep vein thrombosis and concomitant heterozygous prothrombin (factor II) gene mutation (G20210A) was diagnosed during the hospital stay. Because of the severe clinical findings and hereditary thrombophilia, we recommended a lifelong anticoagulant therapy and elastic stockings. Furthermore, different diagnosis and treatment strategies are discussed in case of concomitant prothrombin gene mutation.
authors: Department of Cardiology, Pulmonology and Internal Intensive Care Medicine, Städtisches Klinikum München GmbH, Klinikum Neuperlach, Munich, Germany. stephanstaubach@gmail.com
authors: Stephan
authors: S
authors: Staubach
authors: Martin
authors: M
authors: Hug
authors: Harald
authors: H
authors: Mudra
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D005334:Fever / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D005858:Germany; D006579:Heterozygote; D006801:Humans; D035002:Lower Extremity / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000235:genetics; D017354:Point Mutation; D011516:Prothrombin / Q000235:genetics*; D019851:Thrombophilia / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000235:genetics; D018608:Ultrasonography, Doppler; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000235:genetics
chemical_list: D000925:Anticoagulants; D011516:Prothrombin