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Abstract

 Résumé

La thrombose veineuse n’est pas habituelle chez l’enfant. Elle résulte de la conjonction des facteurs de risque génétiques et acquis. Nous rapportons un cas de thrombose des veines profondes du membre inférieur chez une adolescente de 10 ans souffrant d’un retard de croissance sévère. La patiente porte un syndrome de malabsorption post chirurgical, probablement secondaire à un grêle court. Six mois auparavant, elle avait développé des œdèmes asymétriques bilatéraux des membres inférieurs traités comme kwashiorkor. La patiente n’était pas alitée mais, a été plusieurs fois hospitalisée depuis la naissance pour des complications de la diarrhée. Elle a bénéficié d’une prise en charge nutritionnelle avant la découverte de la thrombose des veines gastrocnémiènne et saphène externe, qui a justifié une héparinothérapie accompagnée d’un traitement par un antagoniste de la vitamine K. Les auteurs relèvent que les œdèmes chez un malnutri sévère peuvent cacher une maladie thromboembolique.

Abstract

 

Deep vein thrombosis is uncommon in children. Both genetic and acquired factors contribute to its genesis.
Here we report a case of deep vein thrombosis of lower limb in a teenager presenting with severe failure to thrive.
Our patient had a post-surgical malabsorption syndrome, likely to be due to a short bowel. Six months earlier she had bilateral edema of both lower limbs that was managed as kwashiorkor.
She was not bed ridden, but has had several admission as in patient since birth for complicated diarrhea. She was underground nutritional rehabilitation when she was diagnosed a thrombosis of both gastrocnemic and external saphenous veins, that was managed with heparin coupled with antivitamine K anticoagulant. We this report that edema could hide deep vein thrombosis in a severely malnourished child.


Article Details

Author Biographies

Paul Koki Ndombo, faculty of medicine and biomedical sciences, The university of Yaoundé1

Departement de pediatrie, Maitre de conferences agrégé, et chef de deartement de pediatrie

Félicité Nguefack, Departement de pediatrie, faculte de medecine et sciences biomédicales, Universite de Yaoundé 1

chargée de cours de pediatrie,, departement de pediatrie

Suzanne Ngo Um Sap, Departement de pediatrie, faculte de medecine et sciences biomédicales, Universite de Yaoundé 1

departement de pediatrie, vacataire
How to Cite
Koki Ndombo, P., Nguefack, F., & Ngo Um Sap, S. (2014). Thrombose veineuse de membre sur un terrain de grêle court et de malabsorption. HEALTH SCIENCES AND DISEASE, 15(4). https://doi.org/10.5281/hsd.v15i4.353

References

  1. Références
  2. Raffini L, Huang Y-S, Witmer C, Feudtner C. Dramatic increase in venous thromboembolism in children’s hospitals in the United States from 2001 to 2007. Pediatrics. 2009 Oct;124(4):1001–8.
  3. Niyazi Çebi, Süleyman T. Aetiology of Deep Vein Thrombosis in 63 Turkish Patients. Turk J Med Sci. 2009;39(2):223–7.
  4. Parasuraman S, Goldhaber SZ. Venous Thromboembolism in Children. Circulation. 2006 Jan 17;113(2):e12–e16.
  5. Richardson MW, Allen GA, Monahan PE. Thrombosis in children: current perspective and distinct challenges. Thromb Haemost. 2002 Dec;88(6):900–11.
  6. Long A, Vitoux JF, Martelli L, Fiessinger JN. Thrombosis of the gastrocnemic veins. A clinical entity. Presse Médicale Paris Fr 1983. 1990 Jun 9;19(23):1081–3.
  7. Macdonald PS, Kahn SR, Miller N, Obrand D. Short-term natural history of isolated gastrocnemius and soleal vein thrombosis. J Vasc Surg. 2003 Mar;37(3):523–7.
  8. Sales CM, Haq F, Bustami R, Sun F. Management of isolated soleal and gastrocnemius vein thrombosis. J Vasc Surg. 2010 Nov;52(5):1251–4.
  9. Andrew M, David M, Adams M, Ali K, Anderson R, Barnard D, et al. Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE. Blood. 1994 Mar 1;83(5):1251–7.
  10. Branchford BR, Mourani P, Bajaj L, Manco-Johnson M, Wang M, Goldenberg NA. Risk factors for in-hospital venous thromboembolism in children: a case-control study employing diagnostic validation. Haematologica. 2012 Apr;97(4):509–15.
  11. Prentiss AS. Early recognition of pediatric venous thromboembolism: a risk-assessment tool. Am J Crit Care Off Publ Am Assoc Crit-Care Nurses. 2012 May;21(3):178–183; quiz 184.
  12. Lazzerini M, Bramuzzo M, Maschio M, Martelossi S, Ventura A. Thromboembolism in pediatric inflammatory bowel disease: systematic review. Inflamm Bowel Dis. 2011 Oct;17(10):2174–83.
  13. Phang M, Lazarus S, Wood LG, Garg M. Diet and thrombosis risk: nutrients for prevention of thrombotic disease. Semin Thromb Hemost. 2011 Apr;37(3):199–208.
  14. Khalil M, Aref MK, Mahmoud S, Abdel-Malek AT, Guirgis FK, Moghazy M, et al. Platelet adhesiveness, plasma free fatty acids, and serum triglycerides in kwashiorkor. Arch Dis Child. 1974 Jul;49(7):568–70.
  15. Bayer-Berger M, Chioléro R, Freeman J, Hirschi B. Incidence of phlebitis in peripheral parenteral nutrition: effect of the different nutrient solutions. Clin Nutr Edinb Scotl. 1989 Aug;8(4):181–6.
  16. Wells PS, Hirsh J, Anderson DR, Lensing AW, Foster G, Kearon C, et al. Accuracy of clinical assessment of deep-vein thrombosis. Lancet. 1995 May 27;345(8961):1326–30.
  17. Brian S, Fries Richard B, Bhagwan S. Clinical characteristics of patients with isolated calf vein thrombosis in a large teaching hospital. Int J Vasc Med. 2011;2011:414093.
  18. Chan AKC, Monagle P. Updates in thrombosis in pediatrics: where are we after 20 years? Hematol Educ Program Am Soc Hematol Am Soc Hematol Educ Program. 2012;2012:439–43.
  19. Baglin T. Unprovoked deep vein thrombosis should be treated with long-term anticoagulation--no. J Thromb Haemost JTH. 2007 Dec;5(12):2336–9.
  20. Mahapatra M, Mishra P, Seth T, Saxena R. Medical management of deep vein thrombosis. East J Med. 2013 Feb 22;14(2):69–72.
  21. Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer J, et al. Evaluation of D-Dimer in the Diagnosis of Suspected Deep-Vein Thrombosis. N Engl J Med. 2003;349(13):1227–35.
  22. Michiels JJ, Gadisseur A, van der Planken M, Schroyens W, Berneman Z, De Maeseneer M, et al. Diagnosis of deep vein thrombosis: how many tests do we need? Acta Chir Belg. 2005 Feb;105(1):16–25.
  23. Fancher TL, White RH, Kravitz RL. Combined use of rapid D-dimer testing and estimation of clinical probability in the diagnosis of deep vein thrombosis: systematic review. BMJ. 2004 Oct 9;329(7470):821.
  24. Smirniotis V, Kotsis TE, Antoniou S, Kostopanagiotou G, Labrou A, Kourias E, et al. Incidence of vein thrombosis in peripheral intravenous nutrition: effect of fat emulsions. Clin Nutr Edinb Scotl. 1999 Apr;18(2):79–81.
  25. Oschman A, Kuhn RJ. Venous Thromboembolism in the Pediatric Population. Smith KM, editor. Orthopedics. 2010 Mar 1;33(3):180–4.
  26. Goldenberg NA, Donadini MP, Kahn SR, Crowther M, Kenet G, Nowak-Göttl U, et al. Post-thrombotic syndrome in children: a systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors. Haematologica. 2010 Nov;95(11):1952–9.
  27. Schneppenheim R, Greiner J. Thrombosis in Infants and Children. ASH Educ Program Book. 2006 Jan 1;2006(1):86–96.

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