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Idiopathic pulmonary fibrosis associated with pulmonary vein thrombosis: a case report.

Cavaco, RA; Kaul, S; Chapman, T; Casaretti, R; Philips, B; Rhodes, A; Grounds, MR (2009) Idiopathic pulmonary fibrosis associated with pulmonary vein thrombosis: a case report. Cases J, 2. p. 9156. ISSN 1757-1626 https://doi.org/10.1186/1757-1626-2-9156
SGUL Authors: Philips, Barbara Rhodes, Andrew

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Abstract

BACKGROUND: Pulmonary vein thrombosis represents a potentially fatal disease. This syndrome may clinically mimic pulmonary embolism but has a different investigation strategy and prognosis. Pulmonary vein thrombosis is difficult to diagnose clinically and usually requires a combination of conventionally used diagnostic modalities. CASE PRESENTATION: The authors report a case of a 78-year-old previously healthy female presenting with collapse and shortness of breath. Serum biochemistry revealed acute kidney injury, positive D-dimmer's and increased C reactive protein. Chest radiography demonstrated volume loss in the right lung. The patient was started on antibiotics and also therapeutic doses of low molecular weight heparin. The working diagnosis included community acquired pneumonia & pulmonary embolism. A computed tomography pulmonary angiogram was performed to confirm the clinical suspicions of pulmonary embolism. This demonstrated a thrombus in the pulmonary vein, with associated fibrosis and volume loss of the right lower lobe. A subsequent thrombophilia screen revealed a positive lupus anticoagulant antibody and rheumatoid factor and also decreased anti thrombin III and protein C levels. The urine protein/creatinine ratio was found to be 553 mg/mmol. CONCLUSION: The diagnosis of this patient was therefore of idiopathic pulmonary fibrosis associated with pulmonary vein thrombosis. Whether or not the pulmonary vein thrombosis was a primary cause of the fibrosis or a consequence of it was unclear. There are few data on the management of pulmonary vein thrombosis, but anticoagulation, antibiotics, and, in cases of large pulmonary vein thrombosis, thrombectomy or pulmonary resection have been used.

Item Type: Article
Additional Information: © Cavaco et al; licensee BioMed Central Ltd. 2009 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: 1199 Other Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cell Sciences (INCCCS)
Journal or Publication Title: Cases J
ISSN: 1757-1626
Language: eng
Dates:
DateEvent
7 December 2009Published
7 December 2009Accepted
Publisher License: Creative Commons: Attribution 2.0
PubMed ID: 20062673
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/110377
Publisher's version: https://doi.org/10.1186/1757-1626-2-9156

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