An interesting case of atypical venous thrombosis with low red blood cells

  • Giuseppe Chiariello Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, Italy.
  • Raimondo Cavallaro Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, Italy.
  • Giuseppe Covetti Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, Italy.
  • Maria Carla Attilia Pisano Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, Italy.
  • Antonella Schettini Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, Italy.
  • Tiziana D'Aniello Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, Italy.
  • Rossella Nappo Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, Italy.
  • Emilio Aliberti Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, United Kingdom.
  • Arcangelo Iannuzzi | arcangelo.iannuzzi@aocardarelli.it Department of Medicine and Medical Specialties, Section of Internal Medicine 2, Antonio Cardarelli Hospital, Naples, Italy.

Abstract

Sex: F Age: 65 years. Recent abdominal colic. Petechial-like manifestations with painful discolored skin lesions (suggestive of dermal veins thromboses) on the chest and abdomen. Blood levels of glucose, electrolytes, amylase, lipase, total protein, renal-function tests, the prothrombin time, the international normalized ratio, the partial-thromboplastin time and albumin were normal. Laboratory testing revealed hemolytic anemia: Red cells 2.94 x10^6/UL; Haemoglobin 8.9 g/dl; Lactate dehydrogenase 950 IU/L. Computed tomography (CT) of the abdomen and pelvis performed after the administration of intravenous contrast material, revealed a central filling defect in the hepatic veins and their branches that was compatible with acute thrombosis of the hepatic veins and their branches. It was suspected paroxysmal nocturnal haemoglobinuria for which flow cytometric analysis was requested.

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Published
2019-10-31
Section
Early Release
Keywords:
Thrombosis, anemia, haemolysis.
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How to Cite
Chiariello, G., Cavallaro, R., Covetti, G., Pisano, M. C. A., Schettini, A., D’Aniello, T., Nappo, R., Aliberti, E., & Iannuzzi, A. (2019). An interesting case of atypical venous thrombosis with low red blood cells. Italian Journal of Medicine, 12. Retrieved from https://italjmed.org/index.php/ijm/article/view/1212