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Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome

The hallmark manifestations of Cushing’s syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmon...

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Autores principales: McDow, Alexandria D., Gurung, Anju, Poola, Rama, Fratianni, Carmel, Garfinkel, Marc, Jakoby, Michael G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405892/
https://www.ncbi.nlm.nih.gov/pubmed/28491882
http://dx.doi.org/10.1177/2324709617703672
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author McDow, Alexandria D.
Gurung, Anju
Poola, Rama
Fratianni, Carmel
Garfinkel, Marc
Jakoby, Michael G.
author_facet McDow, Alexandria D.
Gurung, Anju
Poola, Rama
Fratianni, Carmel
Garfinkel, Marc
Jakoby, Michael G.
author_sort McDow, Alexandria D.
collection PubMed
description The hallmark manifestations of Cushing’s syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmonary venous circulations. We present a case of portal vein thrombosis (PVT) occurring in the setting of newly diagnosed CS due to a left adrenal adenoma. Factor VIII activity was approximately 2.5-fold elevated, a known mechanism by which hypercortisolemia predisposes to venous thrombosis. Acute abdominal pain and fever responded well to unfractionated heparin and parenteral antibiotics, and CS was eventually cured by left adrenalectomy. No thromboembolic events have occurred since surgery. PVT is uncommon and usually occurs as a complication of primary or secondary hepatobiliary malignancies and cirrhosis. To the best of our knowledge, this is just the second reported case of PVT due to CS and the first published in the English language literature.
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spelling pubmed-54058922017-05-10 Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome McDow, Alexandria D. Gurung, Anju Poola, Rama Fratianni, Carmel Garfinkel, Marc Jakoby, Michael G. J Investig Med High Impact Case Rep Case Report The hallmark manifestations of Cushing’s syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmonary venous circulations. We present a case of portal vein thrombosis (PVT) occurring in the setting of newly diagnosed CS due to a left adrenal adenoma. Factor VIII activity was approximately 2.5-fold elevated, a known mechanism by which hypercortisolemia predisposes to venous thrombosis. Acute abdominal pain and fever responded well to unfractionated heparin and parenteral antibiotics, and CS was eventually cured by left adrenalectomy. No thromboembolic events have occurred since surgery. PVT is uncommon and usually occurs as a complication of primary or secondary hepatobiliary malignancies and cirrhosis. To the best of our knowledge, this is just the second reported case of PVT due to CS and the first published in the English language literature. SAGE Publications 2017-04-10 /pmc/articles/PMC5405892/ /pubmed/28491882 http://dx.doi.org/10.1177/2324709617703672 Text en © 2017 American Federation for Medical Research http://creativecommons.org/licenses/by/3.0/ This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
McDow, Alexandria D.
Gurung, Anju
Poola, Rama
Fratianni, Carmel
Garfinkel, Marc
Jakoby, Michael G.
Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome
title Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome
title_full Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome
title_fullStr Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome
title_full_unstemmed Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome
title_short Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome
title_sort portal vein thrombosis in the setting of newly diagnosed cushing’s syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405892/
https://www.ncbi.nlm.nih.gov/pubmed/28491882
http://dx.doi.org/10.1177/2324709617703672
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