Abstract
Sickle cell disease is recognized as a hypercoagulable state;however the frequency and characteristics of venous thromboembolism in sickle cell patients have not been well-defined. We hereby report a case of sickle cell trait with an unusual presentation of serosal involvement and multiple thrombosis of large and small vessels.
A 56 year old female presented with complaints of shortness of breath and cough since 4 months and swelling of both lower limbs since 1 month. She was diagnosed clinically as tubercular pleural effusion at a local hospital and started on anti-tubercular drugs. The treatment, however, was stopped as the patient developed hepatitis. Clinical examination was suggestive of bilateral lower limb pitting edema and a left sided pleural effusion. The recent chest X-ray showed a left sided hydropneumothorax. All routine investigations were within normal limits. Analysis of pleural fluid showed no malignant cells, protein of 3.74mg/dl and ADA of 14IU/L. CECT thorax was suggestive of a thrombus in right pulmonary artery with bilateral minimal pleural effusion and mild pericardial effusion. CECT abdomen showed chronic liver disease with extensive thrombus in extra-hepatic portal vein and splanchnic vein. USG Doppler revealed thrombus at sapheno-femoral junction and in the great saphenous vein. ProteinC and proteinS were within normal limits. Sickling test was positive. HPLC was suggestive of sickle cell heterozygous. The patient was started on anti-coagulation with Tab. Dabigatran and showed improvement.
Venous thromboembolism is not generally recognized as a common comorbidity in sickle cell patients. However, patients may have atypical presentations and should be properly evaluated before initiating any treatment.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA1461.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019