- Email: [email protected]
C0505: Paraneoplasic Venous Thrombosis in a Department of Internal Medecine
S68
POSTERS / Thrombosis Research 133S3 (2014) S35–S123
patients) include aneurysms and occlusions/stenosis. Aneurysms are the most severe arterial complications, particularly pulmonary aneurysms associated with a high risk of massive bleeding. The aim of this study was to investigate complications of patients having vascular manifestations of BD. Methods: This retrospective study examinated vascular complication, in a group of 57 patients with BD hospitalized in internal medicine department. Diagnosis of BD was retained on the presence of criteria of the International Study Group on the BD. Results: Vascular manifestations were found in 13 patients (23%). There were 12 men and 1 woman. Mean age was 38 years. Venous complications were noted in 10 cases: deep vein thrombosis of the lower limbs (9 cases), thrombosis of inferior vena cava (1 case) and cerebral venous thrombosis (1 case). These venous manifestations were the fact discovery of BD in 6 cases. In the other 4 cases, venous complications occurred after an average of 4 years. We noted arterial complications in 3 patients. In one case, arterial location was the first circumstance of discovery of BD. In the other two cases, arterial complications occurred after the diagnosis of BD with an average of 3 years. It was arterial thrombosis of the right lower limb in one case, pulmonary aneurysms in one case and abdominal aortic aneurysms in the last case. All the patients were treated with corticosteroid with a mean dose of 0.5 mg/kg/day associated with anticoagulation by vitamin K antagonist. The outcome was favorable in all the cases. Recurrence of venous thrombosis was reported in one case. No cases of pulmonary embolism were noted in our study. No one of our patient had to receive immunosuppressive drugs. Conclusions: Vascular complications in BD must be actively researched and promptly treated to improve prognosis and overall survival of patients. Treatment is based on corticosteroids and immunosuppressive drugs. The use of anticoagulationin venous thrombosis is still controversial. C0492 VENA CAVA THROMBOSES I. Boukhris1 , I. Kechaou1 , S. Azzabi1 , A. Hariz1 , E. Cherif1 , C. Kooli1 , Z. Kaouech1 , L. ben Hassine1 , N. Khalfallah1 . 1 Medecine Interne. Charles Nicolle Hospital, Tunis, Tunisia Background: Thrombosis of large vessels is less frequent than limb thrombosis. Vena cava is the most frequent of these large vessels thrombosis. Many etiologies can be associated with vena cava thrombosis. Inflammatory diseases are frequently associated with these thromboses. The aim of this study was to study inflammatory diseases associated with vena cava thrombosis. Methods: It’s a retrospective study, searching etiologies of vena cava thrombosis occurring in patients hospitalized in an internal medicine department and confirmed by tomography. Results: In a period of 14 years we noted 29 cases of vena cava thrombosis. In these thromboses there were inflammatory diseases in six cases. We found 4 cases of Behcet’s ¸ disease (BD) and two cases of systemic lupus erythematosus (SLE). In BD, we noted 3 cases of thrombosis of the upper vena cava and one case of thrombosis of lower vena cava. In SLE, there were one case of thrombosis of upper vena cava and one case of lower vena cava. In lupus cases, one patient died after pulmonary embolism. All the other patients have a good evolution after corticosteroids and immunosuppressive drugs. Looking for antiphospholipid antibodies was negative in all the cases. There were no family thrombophilia.
C0505 PARANEOPLASIC VENOUS THROMBOSIS IN A DEPARTMENT OF INTERNAL MEDECINE F. Ajili1 , A. Laanani1 , W. Sassi1 , S. Sameh1 , N. Boussetta1 , J. Laabidi1 , B. Louzir1 , N. Ben Abdelhafidh1 , S. Othmani1 . 1 Military hospital of Tunis. Internal Medicine. Tunis, Tunisia Background: Venous thrombosis is a frequent complication during neoplasia. It may precede the diagnosis and be so revealing it or occur during the course of the disease. Methods: It is a retrospective study in a department of internal medicine, including records of patients hospitalized for deep vein thrombosis (DVT) diagnosed between 2004 and 2013. Search neoplasia associated with DVT has necessitated the systematic practice of abdominal ultrasound, oesogastro-duodenal endoscopy, gynecological examinations for women and an assay of PSA for men. The practice of other tests was guided by clinical and / or paraclinical. Results: Of 100 cases of DVT noted during the same period, 16 cases of paraneoplasic DVT were selected (16% of all DVT). There were 5 women and 11 men, mean age 57 years (36–82 years), 25% of patients were aged more than 65 years. The average BMI was 26.4 kg / m2 . The concept of bed rest (more than 3 days) was found in 32% of cases, a history of recent surgery was noted in 12.5% of cases. A family history of venous thrombosis and an extended trip were found in 6% of cases each. Varices of the lower limbs were observed in 31% of cases. DVT was revealing neoplasia in 57% of cases. The seat of the thrombosis was: the lower limbs (88% of cases), bilaterality was noted in one patient, and the distal localization was observed in 50% of cases, the superior vena cava and inferior in 6% of cases each. A biological inflammatory syndrome was noted in 62% of cases. Neoplasia that were responsible for these DVT: pulmonary adenocarcinoma, bladder neplasia, colonic neoplasia (18.7% of cases each), prostatic adenocarcinoma, chondrosarcoma of the fibula, abdominal sarcoma, metastatic pancreatic neplasia, cervical neuroma, neuroblastoma and breast neplasia (in 6% of cases each). A pulmonary embolism was diagnosed in one patient. Heparin was started in 87.5% of cases relayed by the anti-vitamin K (62%) for an average duration of 6 months. The evolution has been marked by the occurrence of two early deaths, stability to five months without recurrence of thrombosis (31%), and a healing of a bladder tumor after adequate treatment. Conclusions: The pathophysiology of venous thrombosis in cancer is multifactorial. Their incidence appears to be enhanced by the use of hormone therapy or chemotherapy. All cancers may be associated with deep vein thrombosis (DVT), but the use of a comprehensive etiological investigation is discussed. C0508 DEEP VEIN THROMBOSIS (DVT): EPIDEMIOLOGICAL, ETIOLOGICAL AND TOPOGRAPHICAL CHARACTERISTICS OF 100 CASES F. Ajili1 , A. Laanani1 , W. Sassi1 , s. Sayhi1 , N. Boussetta1 , J. Laabidi1 , B. Louzir1 , N. Ben Abdelhafidh1 , S. Othmani1 . 1 Military hospital of Tunis. Internal Medicine. Tunis, Tunisia Background: Venous thromboembolism associates DVT and pulmonary embolism (PE). It is a common clinical situation, causing too much morbidity and even mortality. Methods: It is a retrospective study in a department of internal medicine, including records of 100 patients hospitalized for DVT diagnosed by Doppler ultrasound between 2004 and 2013. We report epidemiological, etiological and topographical characteristics of DVT. Results: There were 54 men and 46 women (sex ratio = 1.17), the mean age was 50.7 years (23–84 years), with 21% of patients over 65 years. As medical history, it was found: diabetes (16% of cases), venous thrombosis (10% of cases), neoplasia and renal failure (7% of cases each), recurrent miscarriages (4% of cases), varicose veins
POSTERS / Thrombosis Research 133S3 (2014) S35–S123
patients) include aneurysms and occlusions/stenosis. Aneurysms are the most severe arterial complications, particularly pulmonary aneurysms associated with a high risk of massive bleeding. The aim of this study was to investigate complications of patients having vascular manifestations of BD. Methods: This retrospective study examinated vascular complication, in a group of 57 patients with BD hospitalized in internal medicine department. Diagnosis of BD was retained on the presence of criteria of the International Study Group on the BD. Results: Vascular manifestations were found in 13 patients (23%). There were 12 men and 1 woman. Mean age was 38 years. Venous complications were noted in 10 cases: deep vein thrombosis of the lower limbs (9 cases), thrombosis of inferior vena cava (1 case) and cerebral venous thrombosis (1 case). These venous manifestations were the fact discovery of BD in 6 cases. In the other 4 cases, venous complications occurred after an average of 4 years. We noted arterial complications in 3 patients. In one case, arterial location was the first circumstance of discovery of BD. In the other two cases, arterial complications occurred after the diagnosis of BD with an average of 3 years. It was arterial thrombosis of the right lower limb in one case, pulmonary aneurysms in one case and abdominal aortic aneurysms in the last case. All the patients were treated with corticosteroid with a mean dose of 0.5 mg/kg/day associated with anticoagulation by vitamin K antagonist. The outcome was favorable in all the cases. Recurrence of venous thrombosis was reported in one case. No cases of pulmonary embolism were noted in our study. No one of our patient had to receive immunosuppressive drugs. Conclusions: Vascular complications in BD must be actively researched and promptly treated to improve prognosis and overall survival of patients. Treatment is based on corticosteroids and immunosuppressive drugs. The use of anticoagulationin venous thrombosis is still controversial. C0492 VENA CAVA THROMBOSES I. Boukhris1 , I. Kechaou1 , S. Azzabi1 , A. Hariz1 , E. Cherif1 , C. Kooli1 , Z. Kaouech1 , L. ben Hassine1 , N. Khalfallah1 . 1 Medecine Interne. Charles Nicolle Hospital, Tunis, Tunisia Background: Thrombosis of large vessels is less frequent than limb thrombosis. Vena cava is the most frequent of these large vessels thrombosis. Many etiologies can be associated with vena cava thrombosis. Inflammatory diseases are frequently associated with these thromboses. The aim of this study was to study inflammatory diseases associated with vena cava thrombosis. Methods: It’s a retrospective study, searching etiologies of vena cava thrombosis occurring in patients hospitalized in an internal medicine department and confirmed by tomography. Results: In a period of 14 years we noted 29 cases of vena cava thrombosis. In these thromboses there were inflammatory diseases in six cases. We found 4 cases of Behcet’s ¸ disease (BD) and two cases of systemic lupus erythematosus (SLE). In BD, we noted 3 cases of thrombosis of the upper vena cava and one case of thrombosis of lower vena cava. In SLE, there were one case of thrombosis of upper vena cava and one case of lower vena cava. In lupus cases, one patient died after pulmonary embolism. All the other patients have a good evolution after corticosteroids and immunosuppressive drugs. Looking for antiphospholipid antibodies was negative in all the cases. There were no family thrombophilia.
C0505 PARANEOPLASIC VENOUS THROMBOSIS IN A DEPARTMENT OF INTERNAL MEDECINE F. Ajili1 , A. Laanani1 , W. Sassi1 , S. Sameh1 , N. Boussetta1 , J. Laabidi1 , B. Louzir1 , N. Ben Abdelhafidh1 , S. Othmani1 . 1 Military hospital of Tunis. Internal Medicine. Tunis, Tunisia Background: Venous thrombosis is a frequent complication during neoplasia. It may precede the diagnosis and be so revealing it or occur during the course of the disease. Methods: It is a retrospective study in a department of internal medicine, including records of patients hospitalized for deep vein thrombosis (DVT) diagnosed between 2004 and 2013. Search neoplasia associated with DVT has necessitated the systematic practice of abdominal ultrasound, oesogastro-duodenal endoscopy, gynecological examinations for women and an assay of PSA for men. The practice of other tests was guided by clinical and / or paraclinical. Results: Of 100 cases of DVT noted during the same period, 16 cases of paraneoplasic DVT were selected (16% of all DVT). There were 5 women and 11 men, mean age 57 years (36–82 years), 25% of patients were aged more than 65 years. The average BMI was 26.4 kg / m2 . The concept of bed rest (more than 3 days) was found in 32% of cases, a history of recent surgery was noted in 12.5% of cases. A family history of venous thrombosis and an extended trip were found in 6% of cases each. Varices of the lower limbs were observed in 31% of cases. DVT was revealing neoplasia in 57% of cases. The seat of the thrombosis was: the lower limbs (88% of cases), bilaterality was noted in one patient, and the distal localization was observed in 50% of cases, the superior vena cava and inferior in 6% of cases each. A biological inflammatory syndrome was noted in 62% of cases. Neoplasia that were responsible for these DVT: pulmonary adenocarcinoma, bladder neplasia, colonic neoplasia (18.7% of cases each), prostatic adenocarcinoma, chondrosarcoma of the fibula, abdominal sarcoma, metastatic pancreatic neplasia, cervical neuroma, neuroblastoma and breast neplasia (in 6% of cases each). A pulmonary embolism was diagnosed in one patient. Heparin was started in 87.5% of cases relayed by the anti-vitamin K (62%) for an average duration of 6 months. The evolution has been marked by the occurrence of two early deaths, stability to five months without recurrence of thrombosis (31%), and a healing of a bladder tumor after adequate treatment. Conclusions: The pathophysiology of venous thrombosis in cancer is multifactorial. Their incidence appears to be enhanced by the use of hormone therapy or chemotherapy. All cancers may be associated with deep vein thrombosis (DVT), but the use of a comprehensive etiological investigation is discussed. C0508 DEEP VEIN THROMBOSIS (DVT): EPIDEMIOLOGICAL, ETIOLOGICAL AND TOPOGRAPHICAL CHARACTERISTICS OF 100 CASES F. Ajili1 , A. Laanani1 , W. Sassi1 , s. Sayhi1 , N. Boussetta1 , J. Laabidi1 , B. Louzir1 , N. Ben Abdelhafidh1 , S. Othmani1 . 1 Military hospital of Tunis. Internal Medicine. Tunis, Tunisia Background: Venous thromboembolism associates DVT and pulmonary embolism (PE). It is a common clinical situation, causing too much morbidity and even mortality. Methods: It is a retrospective study in a department of internal medicine, including records of 100 patients hospitalized for DVT diagnosed by Doppler ultrasound between 2004 and 2013. We report epidemiological, etiological and topographical characteristics of DVT. Results: There were 54 men and 46 women (sex ratio = 1.17), the mean age was 50.7 years (23–84 years), with 21% of patients over 65 years. As medical history, it was found: diabetes (16% of cases), venous thrombosis (10% of cases), neoplasia and renal failure (7% of cases each), recurrent miscarriages (4% of cases), varicose veins