title: [Acute arterial thrombosis in a context of hyperhomocysteinemia: Case report and literature review].
abstract: BACKGROUND
  Hyperhomocysteinemia is a biological marker that could be identified in the venous thrombotic events and rarely during acute arterial thrombotic events. The consequences can be serious. Effective diagnostic strategy is needed to optimize the management.
  
  
  METHODS
  Following bariatric surgery, a 40-year-old patient was admitted with an acute encephalopathy associated with peripheral lower limb arterial ischemia. The diagnostic work-up identified a major hyperhomocysteinemia whose causes were several. Surgical treatment and anticoagulation was associated with vitamins and trace elements supplementation. Correcting deficiencies allowed delirium and hyperhomocysteinemia improvement. Once treatment established, the patient did not present a recurrent thrombotic episode.
  
  
  CONCLUSIONS
  Major hyperhomocysteinemia seems to be associated with an increased risk of acute arterial thrombosis. This marker might be considered in nutritional deficiency situations with appropriate support on the vascular, metabolic and nutrition level.
authors.affiliation: Service de médecine interne et d'explorations vasculaires, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Raybaud
authors.affiliation: Service de médecine interne et d'explorations vasculaires, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France. Electronic address: marc.lambert@chru-lille.fr.
authors.forename: M
authors.initials: M
authors.lastname: Lambert
authors.affiliation: Service d'endocrinologie et métabolisme, centre de référence des maladies héréditaires du métabolisme, hôpital Claude-Huriez, CHRU de Lille, Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Douillard
authors.affiliation: Service hormonologie métabolisme nutrition oncologie, institut de biochimie et biologie moléculaire, centre de biologie pathologie génétique, CHRU de Lille, Lille, France.
authors.forename: A F
authors.initials: AF
authors.lastname: Dessein
authors.affiliation: Service de médecine interne et d'explorations vasculaires, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Morell-Dubois
authors.affiliation: Service de chirurgie vasculaire, hôpital Cardiologique, CHRU de Lille, Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Guillou
authors.affiliation: Service de chirurgie vasculaire, hôpital Cardiologique, CHRU de Lille, Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Haulon
authors.affiliation: Service de médecine interne et d'explorations vasculaires, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Hatron
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D001158:Arteries / Q000473:pathology; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D013927:Thrombosis / Q000209:etiology*
chemical_list: D000925:Anticoagulants
keywords: Arterial thrombosis; Hyperhomocysteinemia; Hyperhomocystéinémie; Thrombose artérielle