Open AccessDeep vein thrombosis and recurrent pulmonary embolism in a patient with thrombophilic mutations and generalized psoriasis: A case report
Author(s) -
Marjan Baloski,
Daniela Buklioska Ilievska,
Vesna Brishkovska-Boshkovski,
Taner Hasan,
Natasa Nedeska Minova,
Biljana Prgova-Veljanova,
Andrea Nanceva Bogoevska,
Jasminka Nanceva,
Marijan Bosevski,
Сашо Панов
Publication year - 2020
Publication title -
sanamed
Language(s) - English
Resource type - Journals
eISSN - 2217-8171
pISSN - 1452-662X
DOI - 10.24125/sanamed.v15i2.391
Subject(s) - medicine , hyperhomocysteinemia , thrombophilia , pulmonary embolism , venous thrombosis , psoriasis , risk factor , factor v , deep vein , factor v leiden , thrombosis , dermatology
Introduction: Genetic risk factors that increase venous thromboembolism risk are disorders in the synthesis or activity of coagulation factors. Factor V Leiden, prothrombin (20210-A), antithrombin deficiency, protein C and protein S deficiency, and hyperhomocysteinemia are the most common venous thromboembolism-related gene mutations. When genetic factors are combined with non-provoking risk factors (obesity, psoriasis, smoking and previous venous thromboembolism) the result is increased venous thromboembolism risk for each factor individually. Previous venous thromboembolism is one of the strongest risk factors, even in patients actively treated with anticoagulants. Patients are more likely to have recurrent venous thromboembolism with longer duration. Psoriasis is a complex immune-mediated disease, associated with cardiovascular risk, hypercoagulability markers and elevated homocysteine. Lots of observational reports suggest increased incidence of venous thromboembolic events in patient with psoriasis. Case presentation: We present patient with inherited thrombophilia and chronic diffuse plaque psoriasis complicated with deep venous thrombosis and pulmonary embolism. DNA analysis indicates the presence of homozygosis for Factor V Leiden mutation as well as heterozygosis for Factor XIII V34L, PAI-1 5G/4G and MTHFR A1298C polymorphism. Dermatological anamnesis is positive for plaque psoriasis since 12 years ago. Conclusion: The presentation of this case indicates an association between venous thromboembolism and chronic psoriasis. All patients with recurrent thromboembolism, hereditary thrombophilia, and moderate to severe psoriasis should be considered to be at higher risk for venous thromboembolism and appropriately treated.