Open AccessRecurrent epistaxis revealing a non-catheter-related superior vena cava syndrome in a hemodialysis patient: Unmasking undifferentiated connective tissue disease
Author(s) -
Omar Dahmani,
Pascale Demarchi,
Christine Sophoclis,
K Abi-ayad,
S Belkhalfa,
J Djellid
Publication year - 2014
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.124522
Subject(s) - medicine , superior vena cava syndrome , hemodialysis catheter , surgery , dialysis catheter , hemodialysis , mediastinum , jugular vein , superior vena cava , catheter , connective tissue , radiology , pathology
We report a case of an 80-year-old Caucasian woman on maintenance hemodialysis for almost three years through a right-tunneled jugular catheter. She presented with recurrent epistaxis for which she was periodically blood transfused despite erythropoietin therapy. She continued manifesting epistaxis, which was progressively emerging as a sign related to superior vena cava syndrome due to mediastinal mass. Laboratory investigations revealed active immunological abnormalities thereafter. Malignant superior vena syndrome remains an uncommon com-plication in this population related to a history of or ongoing central vein catheterization. Prolonged oozing from the vascular site was the first alerting sign of the existence of this syndrome. We conclude that sometimes the transformation of undifferentiated connective tissue disease in the presence of epidermoid carcinoma of the superior mediastinum may be revealed during the use of catheters in dialysis.