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Acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction
A woman in her 50s developed iron deficiency anaemia. Her medical history included hypertension, asthma and remote postpartum pulmonary embolism. There was a strong family history of atherosclerosis. After receiving intravenous iron sucrose (500 mg), she developed vomiting and large-volume diarrhoea...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537970/ https://www.ncbi.nlm.nih.gov/pubmed/37758660 http://dx.doi.org/10.1136/bcr-2023-255702 |
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author | Okaj, Iva Pai, Menaka Harlock, John Warkentin, Theodore Earl |
author_facet | Okaj, Iva Pai, Menaka Harlock, John Warkentin, Theodore Earl |
author_sort | Okaj, Iva |
collection | PubMed |
description | A woman in her 50s developed iron deficiency anaemia. Her medical history included hypertension, asthma and remote postpartum pulmonary embolism. There was a strong family history of atherosclerosis. After receiving intravenous iron sucrose (500 mg), she developed vomiting and large-volume diarrhoea, followed by diaphoresis, back pain, haemoconcentration (haematocrit increase, 0.242 to 0.326), leucocytosis and platelet count decline. Myocardial infarction was ruled out and the truncal pain subsided. However, 2 days postdischarge, she was diagnosed with aortic intraluminal thrombus (ILT) with embolisation into the lower extremities. The limbs were salvaged by emergency embolectomies and fasciotomies. Acute aortic ILT is a rare disorder that has not been previously reported as a complication of parenteral iron therapy. We postulate that acute intravascular volume losses (vomiting and diarrhoea) with resulting haemoconcentration and catecholamine-associated platelet activation and consumption, in a patient with subclinical aortic atherosclerosis, triggered acute aortic ILT presenting as lower-limb ischaemia. |
format | Online Article Text |
id | pubmed-10537970 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-105379702023-09-29 Acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction Okaj, Iva Pai, Menaka Harlock, John Warkentin, Theodore Earl BMJ Case Rep Case Reports: Adverse drug reactions and complications A woman in her 50s developed iron deficiency anaemia. Her medical history included hypertension, asthma and remote postpartum pulmonary embolism. There was a strong family history of atherosclerosis. After receiving intravenous iron sucrose (500 mg), she developed vomiting and large-volume diarrhoea, followed by diaphoresis, back pain, haemoconcentration (haematocrit increase, 0.242 to 0.326), leucocytosis and platelet count decline. Myocardial infarction was ruled out and the truncal pain subsided. However, 2 days postdischarge, she was diagnosed with aortic intraluminal thrombus (ILT) with embolisation into the lower extremities. The limbs were salvaged by emergency embolectomies and fasciotomies. Acute aortic ILT is a rare disorder that has not been previously reported as a complication of parenteral iron therapy. We postulate that acute intravascular volume losses (vomiting and diarrhoea) with resulting haemoconcentration and catecholamine-associated platelet activation and consumption, in a patient with subclinical aortic atherosclerosis, triggered acute aortic ILT presenting as lower-limb ischaemia. BMJ Publishing Group 2023-09-27 /pmc/articles/PMC10537970/ /pubmed/37758660 http://dx.doi.org/10.1136/bcr-2023-255702 Text en © BMJ Publishing Group Limited 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Case Reports: Adverse drug reactions and complications Okaj, Iva Pai, Menaka Harlock, John Warkentin, Theodore Earl Acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction |
title | Acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction |
title_full | Acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction |
title_fullStr | Acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction |
title_full_unstemmed | Acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction |
title_short | Acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction |
title_sort | acute aortic intraluminal thrombus with embolisation and lower-limb ischaemia following intravenous iron sucrose infusion reaction |
topic | Case Reports: Adverse drug reactions and complications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537970/ https://www.ncbi.nlm.nih.gov/pubmed/37758660 http://dx.doi.org/10.1136/bcr-2023-255702 |
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