RESUMO
Pregnancy is a well-known risk factor of venous thromboembolism. We retrospectively reviewed case histories of 82 pregnant women who developed symptoms of venous pathology, thrombophlebitis, deep vein thrombosis (DVT) or pulmonary embolus (PE) while receiving care at our hospital. We found the VTE risk identification and documentation during their pregnancies were deficient resulting in the omission of appropriate thromboprophylaxis. Many confirmed VTE cases (antenatally or postpartum) were not on thromboprophylaxis prior to diagnosis despite having multiple risk factors. We recommend the use of a risk assessment tool by clinicians for accurate risk identification ensuring proper risk management at different stages of pregnancy.
Assuntos
Embolia Pulmonar , Tromboembolia Venosa , Feminino , Humanos , Gravidez , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle , Anticoagulantes/efeitos adversos , Estudos Retrospectivos , Embolia Pulmonar/etiologia , Embolia Pulmonar/prevenção & controle , Embolia Pulmonar/diagnóstico , Fatores de Risco , Medição de RiscoRESUMO
An 82-year-old woman who initially presented with pulmonary infection had persistent pancytopenia, which presented a diagnostic dilemma requiring multiple bone marrow biopsies for eventual diagnosis of hemophagocytic lymphohistiocytosis. This case highlights the utility of FDG PET in (a) focusing attention on the bone marrow and reticuloendothelial system as the primary site of pathology and (b) excluding underlying malignancy and infection in this rare but potentially fatal hyperinflammatory condition caused by a highly stimulated but ineffective immune response.
