Fatal pulmonary embolism due to ınherited thrombophilia factors in a child with wolfram syndrome

Autor: Yasemin Isik Balci, Dolunay Gürses, Serap Semiz, Tamer Özsari, Kazım Küçüktaşçı, Mustafa Saçar, Ender Semiz, Gökhan Önem, Füsun Düzcan, Doğangün Yüksel
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Pediatrics
desmopressin
pulmonary embolism
loading drug dose
resuscitation
030204 cardiovascular system & hematology
heparin
thrombofilia risk factors
physical examination
protein C
rheumatoid factor
computer assisted tomography
0302 clinical medicine
diabetic ketoacidosis
Fatal Outcome
methylenetetrahydrofolate reductase gene
echocardiography
Thrombophilia
genetics
gene mutation
C reactive protein
biology
heart atrium thrombosis
Factor V
single drug dose
enoxaparin
optic nerve atrophy
Hematology
Thrombosis
Pulmonary embolism
blood clotting factor 5
female
Oncology
priority journal
risk factor
diabetes insipidus
thrombectomy
laboratory test
diabetes mellitus
activated protein C resistance
lung embolism
medicine.medical_specialty
insulin
Diabetic ketoacidosis
cardiopulmonary arrest
Adolescent
Wolfram syndrome
methylenetetrahydrofolate reductase (NADPH2)
030209 endocrinology & metabolism
complication
embolism
insulin dependent diabetes mellitus
Article
03 medical and health sciences
clinical examination
fatality
medicine
case report
degenerative disease
heterozygosity
Humans
human
Thrombus
gene
thrombosis
business.industry
Glasgow coma scale
hearing impairment
thromboembolism
medicine.disease
ceftriaxone
warfarin
blood clotting factor 5 Leiden
Diabetes Mellitus
Type 1

Pediatrics
Perinatology and Child Health

biology.protein
Activated protein C resistance
homozygosity
business
Popis: Wolfram syndrome-1 is a rare and severe autosomal recessive neurodegenerative disease characterized by diabetes mellitus (DM), optic atrophy, diabetes insipidus, and deafness. Poorly controlled type 1 DM increases the risk for thrombosis. However, coexistence of DM and hereditary thrombosis factors is rarely observed. Here we present the case of a 13.5-year-old, nonfollowed girl newly diagnosed with poorly controlled Wolfram syndrome on the basis of the results of clinical and laboratory examinations. On the eighth day after diabetic ketoacidosis treatment, pulmonary embolism developed in the subject. Thrombus identified in the right atrium using echocardiography was treated by emergency thrombectomy. Homozygous mutation in the methylenetetrahydrofolate reductase gene C677T, heterozygous factor-V Leiden mutation, and active protein C resistance were identified in the patient. The patient was lost because of a recurring episode of pulmonary embolism on the 86th day of hospitalization. We present this case to highlight the need for investigating hereditary thrombosis risk factors in diabetic patients in whom thromboembolism develops. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Databáze: OpenAIRE