ABSTRACT
BACKGROUND: The interrelation of cancer with venous thromboembolism is established, yet the specific impact on the incidence and progression of superficial vein thrombosis (SVT) remains unclear. OBJECTIVES: To investigate the association between SVT and malignancies, focusing on risk factors, presentation, course and complications. METHODS: A single-center prospective observational study of patients diagnosed with DVT or SVT referred to a venous thromboembolism clinic between January 2013 and April 2018. RESULTS: Of the 632 patients, 205 presented with SVT at referral, 16.6% having active cancer. Significant associations were found between active cancer and the risk of developing proximal SVT (RR 1.54 [1.18-2.03] p < 0.01), SVT within 3 cm from junction (RR 2.01 [1.13-3.72] p = 0.019), bilateral SVT (RR 8.38 [2.10-33.43] p < 0.01) and SVT affecting multiple veins (RR 2.42 [1.40-4.20] p < 0.01), with a higher risk of persistence (RR 1.51 [1.18-1.95] p < 0.01) and progression (RR 5.75 [2.23-14.79] p < 0.01) at initial assessment. Patients with SVT and no malignancy history demonstrated an elevated risk for new-onset cancer during follow-up (RR 1.43 [1.13-1.18] p = 0.022), especially in cases of proximal or bilateral SVT, initial progression or subsequent DVT or PE. No significant differences were observed in persistence, recurrence or complications during initial evaluation or follow-up across different pharmacological treatments. CONCLUSIONS: Research suggests a probable link between cancer history and the development of SVT. SVT presented more severely in cancer patients. SVT, especially in its more complex forms, could serve as a predictive marker for the future development of cancer. Treatment approaches varied, no significant differences in outcomes were noted.
Subject(s)
Neoplasms , Venous Thromboembolism , Venous Thrombosis , Humans , Venous Thromboembolism/drug therapy , Anticoagulants/therapeutic use , Venous Thrombosis/diagnosis , Risk Factors , Neoplasms/complicationsABSTRACT
Las manifestaciones clínicas de la COVID-19 son múltiples y variadas. Últimamente se han descrito lesiones cutáneas inespecíficas, más frecuentemente en niños y adolescentes, a veces como único síntoma clínico o en el contexto del cuadro típico de la infección. Presentamos el caso de un niño de 10 años con manifestaciones cutáneas como única clínica de infección por SARS-CoV-2 en el contexto epidemiológico y familiar propio de la enfermedad. Las situaciones de pandemia incrementan la relevancia de ampliar la sospecha diagnóstica ante cualquier tipo de síntomas e incluir aspectos epidemiológicos en el proceso diagnóstico. El pronóstico en niños sin comorbilidades, por lo general, es favorable, debiendo prestar especial atención a los signos inflamatorios y protrombóticos secundarios al SARS-CoV-2
Clinical manifestations of COVID-19 are multiple and varied. Non-specific skin lesions have been lately described, more frequently in children and adolescents, sometimes as the only clinical symptom or in the context of the typical picture of the infection. We present the case of a 10-year-old boy with skin manifestations as the only symptom of SARS-CoV-2 infection in the epidemiological and family context of the disease. Pandemic situations increase the relevance of extending diagnostic suspicion at any kind of symptom, and to include epidemiological aspects in the diagnostic process. Prognosis in children without comorbidities is usually favourable, but particular attention should be paid to inflammatory and prothrombotic signs secondary to SARS-CoV-2