[Paget-Schroetter síndrome associated with hyperhomocsyteinemia]. / Síndrome de Paget-Schroetter asociado a hiperhomocisteinemia.

Venous thromboembolic disease (VTED) in the upper extremities is an infrequent entity, although its incidence has increased in relation to the use of central venous catheters. Its etiology can be primary (idiopathic, spontaneous, due to effort or traumatic) or secondary (related to tumours, central venous catheters, etc.). We present a case of primary venous thrombosis of the upper right extremity, also called the Paget-Schroetter syndrome. This clinical picture is usually associated with intensive and/or repetitive exercise or effort of the affected extremity, anatomical alterations in the zone, or it can be the first manifestation of a previously unknown thrombophilic state, as in the case that concerns us. The clinical picture usually consists of pain in the affected extremity, frequently accompanied by edema and collateral circulation. Echography-Doppler frequently presents false negatives, and it is recommendable to carry out CAT, due to its greater specificity and for evaluating the neighbouring structures, although flebography continues to be the cardinal test for diagnosing this picture. There is no unanimity of opinion concerning treatment, and it is recommendable that this should be individualised in accordance with the characteristics of each case.

Síndrome de Paget-Schroetter asociado a hiperhomocisteinemia / Paget-Schroetter síndrome associated with hyperhomocsyteinemia

La enfermedad tromboembólica venosa (ETEV) en extremidades superiores es una entidad poco frecuente, si bien su incidencia ha aumentado en relación con el empleo de catéteres venosos centrales. La etiología puede ser primaria (idiopática, espontánea, de esfuerzo o traumática) o secundaria (relacionada con tumores, catéteres venosos centrales, etc.). Presentamos un caso de trombosis venosa primaria de extremidad superior derecha, también llamada síndrome de Paget- Schroetter. Este cuadro suele asociarse a ejercicios o esfuerzos intensos y/o repetitivos de la extremidad afecta, alteraciones anatómicas en la zona, o bien puede ser la primera manifestación de un estado trombofílico desconocido hasta ese momento, como en el caso que nos ocupa. La clínica suele consistir en dolor en extremidad afecta, acompañado frecuentemente de edema y circulación colateral. La ecografía-doppler presenta con frecuencia falsos negativos, recomendando la realización de TAC por su mayor especificidad y para valoración de las estructuras vecinas, aunque la flebografía continúa siendo la prueba oro para el diagnóstico de este cuadro. No existe unanimidad acerca del tratamiento, recomendándose individualizar de acuerdo con las características propias de cada caso

Venous thromboembolic disease (VTED) in the upper extremities is an infrequent entity, although its incidence has increased in relation to the use of central venous catheters. Its etiology can be primary (idiopathic, spontaneous, due to effort or traumatic) or secondary (related to tumours, central venous catheters, etc.). We present a case of primary venous thrombosis of the upper right extremity, also called the Paget-Schroetter syndrome. This clinical picture is usually associated with intensive and/or repetitive exercise or effort of the affected extremity, anatomical alterations in the zone, or it can be the first manifestation of a previously unknown thrombophilic state, as in the case that concerns us. The clinical picture usually consists of pain in the affected extremity, frequently accompanied by edema and collateral circulation. Echography-Doppler frequently presents false negatives, and it is recommendable to carry out CAT, due to its greater specificity and for evaluating the neighbouring structures, although flebography continues to be the cardinal test for diagnosing this picture. There is no unanimity of opinion concerning treatment, and it is recommendable that this should be individualised in accordance with the characteristics of each case