RESUMEN
Retinal artery occlusion is rare in young adults, and may be associated with hereditary thrombophilia. We present a 19-year-old male who was evaluated for central retinal artery occlusion and found to be homozygous for the factor V Leiden mutation and heterozygous for the prothrombin G20210A mutation. Anterior chamber paracenthesis resulted in dramatic improvement, but recurring loss of vision necessitated repeated paracenthesis and the addition of aspirin to standard anticoagulation treatment. The literature concerning hereditary thrombophilia and retinal artery occlusion is reviewed, and the synergistic effect of multiple risk factors is emphasized. Screening for hereditary thrombophilia should be considered for young people presenting with unexplained retinal artery occlusion.
Asunto(s)
Factor V/genética , Oclusión de la Arteria Retiniana/genética , Trombofilia/complicaciones , Adulto , Anticoagulantes/administración & dosificación , Homocigoto , Humanos , Masculino , Paracentesis , Mutación Puntual , Protrombina/genética , Oclusión de la Arteria Retiniana/sangre , Oclusión de la Arteria Retiniana/etiología , Trombofilia/genéticaAsunto(s)
Enfermedades del Ano/diagnóstico , Enfermedad de Crohn/diagnóstico , Adolescente , Enfermedades del Ano/microbiología , Niño , Abuso Sexual Infantil/diagnóstico , Diagnóstico Diferencial , Errores Diagnósticos , Femenino , Humanos , Papillomaviridae , Infecciones por Papillomavirus/diagnóstico , Infecciones Tumorales por Virus/diagnósticoRESUMEN
The evaluation of an emergency room patient with acute chest pain is often difficult. Recently, computers have been employed to develop protocols for identifying which patients are likely to have acute myocardial infarctions and to benefit, therefore, from admission to a relatively scarce coronary care unit bed. We have tested the latest computer-derived instrument in a municipal hospital and found it to be less reliable than the clinical judgement of physicians.