Description
A previously healthy 21-year-old man presented with back pain, bilateral extremity pain, and right lower extremity weakness, paresthesias, and swelling. Sonographic examination revealed diffuse deep vein thrombosis (DVT) in the femoral and popliteal venous system. CT imaging revealed hypoplasia of the hepatic inferior vena cava (IVC) segment with formation of multiple varices and collateral veins around the kidneys. Hematologic workup also discovered a factor V Leiden mutation, further predisposing the patient to DVT. The rare, often overlooked occurrence of attenuated IVC, especially in the setting of hypercoagulable state, can predispose patients to significant thrombosis.
Subject
Humans; Male; Young Adult; Ultrasonography; *Mutation; Risk Factors; Predictive Value of Tests; Genetic Predisposition to Disease; Activated Protein C Resistance/*complications/diagnosis/drug therapy/genetics; Anticoagulants/therapeutic use; deep vein thrombosis (DVT); DNA Mutational Analysis; Factor V/*genetics; inferior vena cava (IVC); lower extremities; Phlebography/methods; thrombophilic; Vascular Malformations/*complications/diagnosis; venography; Venous Thrombosis/diagnosis/drug therapy/*etiology/genetics; Mutation; Tomography; Human; X-Ray Computed; Sequence Analysis; Vena Cava; Inferior/*abnormalities/diagnostic imaging; Venous Thrombosis; Blood Coagulation Factors; Disease Susceptibility; Hematologic Diseases; Venous Thrombosis – Drug Therapy; Anticoagulants – Therapeutic Use; Hematologic Diseases – Complications; Hematologic Diseases – Diagnosis; Hematologic Diseases – Drug Therapy; Inferior – Abnormalities; Inferior – Radiography; Inferior – Ultrasonography; Phlebography – Methods; Vascular Malformations – Complications; Vascular Malformations – Diagnosis; Venous Thrombosis – Diagnosis; Venous Thrombosis – Etiology