Pulmonary thromboembolism in AIDS patient with chronic venous insufficiency, pulmonary tuberculosis and breast cancer: a case report and pathophysiology review

Cortez-Escalante, Juan José; Castro, Cleudson; Romero, Gustavo; Matos, Luiza; Saif, Muhammad Wasif

doi:10.1590/s0036-46652006000200010

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…Our search yielded 129 cases, including our 17 cases10, 16, 17, 20, 22, 26, 31-33, 46-81. Forty-eight of the cases occurred prior to HAART (published before 1997 accounting for the lag time of publication) with the first cases being reported in 198646, 47; 81 cases have been reported in the literature after the widespread availability of HAART (1997-2007).…”

Section: Resultsmentioning

confidence: 99%

Review:Thromboses among HIV-Infected Patients during the Highly Active Antiretroviral Therapy Era

Crum-Cianflone

Weekes²,

Bavaro³

2008

AIDS Patient Care and STDs

103

148

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Venous thrombotic events (VTEs) may occur at higher rates among HIV patients; some studies suggest that HAART may increase the risk for these potentially life-threatening events. We performed a retrospective study among HIV patients to evaluate the incidence and risk factors for VTEs during the HAART era. A literature review was performed examining VTEs in the pre-and post HAART eras. Seventeen (3.7%) of 465 HIV patients experienced a VTE. The overall incidence rate of deep VTEs among HIV positive persons was 377 cases/100,000 person-years, a four-fold higher rate compared to age-matched males in the general population. The median age at VTE was 36 years (range 27-68). Patients with a thrombosis compared to those without had significantly lower current CD4 (153 vs. 520 cells/mm 3 , p<0.001) and nadir (76 vs. 276 cells/mm 3 , p<0.001) CD4 counts, higher viral loads (3.6 vs. 1.7 log 10 copies/ml, p=0.003), and more likely to have a diagnosis of AIDS (76% vs. 32%, p<0.001); there were no differences in demographics, hyperlipidemia, current use of HAART, the duration of HAART or PI exposure. A review of the literature noted 129 VTE cases; mean age was 40 years, mean CD4 count was 181 cells/mm 3 , the majority of patients were not receiving HAART, and the most common risk factor was an ongoing infection. Thrombotic events are occurring among HIV patients despite their relatively young ages. Advanced HIV disease is a risk factor for development of thromboses, possibly due to an increased inflammatory state or the presence of concurrent comorbidities such as infections. HAART or PI therapy does not appear to play a significant role in the occurrence of VTEs.

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Section: Resultsmentioning

confidence: 99%

Review:Thromboses among HIV-Infected Patients during the Highly Active Antiretroviral Therapy Era

Crum-Cianflone

Weekes²,

Bavaro³

2008

AIDS Patient Care and STDs

103

148

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“…AIDS is considered to present many risk factors for VTE, including frequent hospitalization, the use of central venous catheters, an age older than 45 years, and the activation of endothelial cells from infections with cytomegalovirus, herpes, and HIV itself (34,35). The mean age of the AIDS patients in our study was 43.7 years, and the average hospital stay of these patients was only 11.1 days.…”

Section: Discussionmentioning

confidence: 99%

Fatal pulmonary embolism in hospitalized patients: a large autopsy-based matched case-control study

Bricola¹,

Paiva²,

Lichtenstein³

et al. 2013

Clinics

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OBJECTIVE:Pulmonary embolism is an underdiagnosed major cause of death for hospitalized patients. The objective of this study was to identify the conditions associated with fatal pulmonary embolism in this population.METHODS:A total of 13,074 autopsy records were evaluated in a case-control study. Patients were matched by age, sex, and year of death, and factors potentially associated with fatal pulmonary embolism were analyzed using univariate and multivariate conditional logistic regression.RESULTS:Pulmonary embolism was considered fatal in 328 (2.5%) patients. In the multivariate analysis, conditions that were more common in patients who died of pulmonary embolism were atherosclerosis, congestive heart failure, and neurological surgery. Some conditions were negatively associated with fatal pulmonary embolism, including hemorrhagic stroke, aortic aneurism, cirrhosis, acquired immune deficiency syndrome, and pneumonia. In the control group, patients with hemorrhagic stroke and aortic aneurism had short hospital stays (8.5 and 8.8 days, respectively), and the hemorrhage itself was the main cause of death in most of them (90.6% and 68.4%, respectively), which may have prevented the development of pulmonary embolism. Cirrhotic patients in the control group also had short hospital stays (7 days), and 50% died from bleeding complications.CONCLUSIONS:In this large autopsy study, atherosclerosis, congestive heart failure, and neurological surgery were diagnoses associated with fatal pulmonary embolism.

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Deep venous thrombosis associated with tuberculosis

Naithani¹,

Agrawal²,

Choudhary³

2007

Blood Coagulation &Amp; Fibrinolysis

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There is an association between inflammation and hemostatic changes that can result in a hypercoagulable state. We report a 34-year-old male who presented with a second episode of deep vein thrombosis. Tuberculosis was diagnosed while looking for secondary causes. The patient was treated with rifampicin, isoniazid, pyrazinamide and ethambutol along with low-molecular-weight heparin and warfarin. Tuberculosis has several mechanisms that induce a hypercoagulable state and can lead to thromboembolic complications.

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Pulmonary thromboembolism in AIDS patient with chronic venous insufficiency, pulmonary tuberculosis and breast cancer: a case report and pathophysiology review

Cited by 4 publications

References 33 publications

Review:Thromboses among HIV-Infected Patients during the Highly Active Antiretroviral Therapy Era

Review:Thromboses among HIV-Infected Patients during the Highly Active Antiretroviral Therapy Era

Fatal pulmonary embolism in hospitalized patients: a large autopsy-based matched case-control study

Deep venous thrombosis associated with tuberculosis

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