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Rev Med Interne ; 41(9): 628-631, 2020 Sep.
Article in French | MEDLINE | ID: mdl-32565074

ABSTRACT

INTRODUCTION: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease characterized by the triad of nose bleeding, telangiectasia and familial heredity. CASE REPORT: We report the case of a patient who had idiopathic venous cerebral thrombosis complicated by a cerebral infarction treated with warfarin. In the context of a psoas hematoma by warfarine overdose and immobilization, the patient had deep vein thrombosis of the left lower limb with pulmonary embolism revealing a pulmonary arteriovenous malformation. After a reexamination, the patient clinical phenotype of HHT was confirmed genetically. The patient was treated with rivaroxaban allowing clinical improvement and partial recanalization of all thrombosis after six months. Thrombotic overisk has already been studied in HHT patients but the use of anticoagulants is at higher risk in these patients. However this patient experienced no adverse event with rivaroxaban. CONCLUSION: This is the first case described of cerebral venous thrombosis treated with rivaroxaban revealing an HHT.


Subject(s)
Intracranial Thrombosis/etiology , Telangiectasia, Hereditary Hemorrhagic/diagnosis , Venous Thrombosis/etiology , Anticoagulants/therapeutic use , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/drug therapy , Arteriovenous Fistula/etiology , Delayed Diagnosis , Diagnosis, Differential , Humans , Intracranial Thrombosis/diagnosis , Intracranial Thrombosis/drug therapy , Late Onset Disorders , Magnetic Resonance Imaging , Male , Middle Aged , Pulmonary Artery/abnormalities , Pulmonary Embolism/diagnosis , Pulmonary Embolism/drug therapy , Pulmonary Embolism/etiology , Pulmonary Veins/abnormalities , Rivaroxaban/therapeutic use , Telangiectasia, Hereditary Hemorrhagic/complications , Telangiectasia, Hereditary Hemorrhagic/drug therapy , Venous Thrombosis/diagnosis , Venous Thrombosis/drug therapy
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