scholarly journals Deep Venous Thrombosis in Patients with Erythema Nodosum Leprosum in the Use of Thalidomide and Systemic Corticosteroid in Reference Service in Belo Horizonte, Minas Gerais

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Luiz Alberto Bomjardim Pôrto ◽  
Maria Aparecida de Faria Grossi ◽  
Edilamar Silva de Alecrim ◽  
Marcus Henrique de Souza Brito Xavier ◽  
Frederico Paiva e Silva ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Venous Insufficiency ◽  
Erythema Nodosum ◽  
Case Series ◽  
Erythema Nodosum Leprosum ◽  
Reference Service ◽  
Belo Horizonte ◽  
Pharmacological Thromboprophylaxis ◽  
Incidence Increase

Introduction. Erythema nodosum leprosum (ENL) is a type of lepra reaction treated with corticosteroids and thalidomide, but this association increases the risk of deep venous thrombosis (DVT).Objective. To report cases of ENL with DVT in the use of thalidomide/corticosteroid associated.Methodology. The study was conducted between December 2015 and December 2016 at the Eduardo de Menezes Hospital (HEM-FHEMIG).Results. A clinical case series of 16 patients, eight from HEM-FHEMIG and eight from the literature. DVT occurred on 4 continents, mainly in adults and men. All patients were multibacillary; four people had pulmonary embolism (PE); there were 11 unilateral and five bilateral DVT cases; 12 cases were proximal, two distal, and two unspecified. Pharmacological thromboprophylaxis was used on two individuals. Outcome after DVT, 14 patients improved, one had sequelae, and one died.Discussion. DVT increased in association with thalidomide/corticosteroid in multiple myeloma, but this complication is poorly described in ENL. In proximal DVT, there was a greater risk of PE and sequelae venous insufficiency. After DVT, start anticoagulation. ASA 100mg/day as prophylaxis for DVT in case of this drug association in ENL is recommended.Conclusion. The article illustrates the incidence increase of DVT because of the thalidomide/corticosteroid combination in ENL. When this association is necessary, use ASA 100mg/day as prophylaxis.

Unusual non-trophic ulcerations in leprosy: A case series of 17 patients

2021 ◽  
pp. 004947552199849
Author(s):  
Prakriti Shukla ◽  
Kiran Preet Malhotra ◽  
Parul Verma ◽  
Swastika Suvirya ◽  
Abir Saraswat ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Case Series ◽  
Lepromatous Leprosy ◽  
Sweet Syndrome ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients ◽  
Atypical Presentations ◽  
Neuropathic Ulcers

Non-neuropathic ulcers in leprosy patients are infrequently seen, and atypical presentations are prone to misdiagnosis. We evaluated diagnosed cases of leprosy between January 2017 and January 2020 for the presence of cutaneous ulceration, Ridley–Jopling subtype of leprosy, reactions and histologic features of these ulcerations. Treatment was given as WHO recommended multi-bacillary multi-drug therapy. We found 17/386 leprosy patients with non-neuropathic ulcers. We describe three causes – spontaneous cutaneous ulceration in lepromatous leprosy (one nodular and one diffuse), lepra reactions (five patients with type 1; nine with type 2, further categorised into ulcerated Sweet syndrome-like who also had pseudoepitheliomatous hyperplasia, pustulo-necrotic and necrotic erythema nodosum leprosum) and Lucio phenomenon (one patient). Our series draws attention towards the different faces of non-neuropathic ulcers in leprosy, including some atypical and novel presentations.

scholarly journals Anticoagulation alone versus combined catheter-directed thrombolysis and anticoagulation in treatment of acute ilio-femoral deep venous thrombosis

2019 ◽  
Vol 6 (8) ◽  
pp. 2698
Author(s):  
Mostafa A. Elaggory ◽  
Mahmoud S. Eldesouky ◽  
Nehad A. Zeid
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Anticoagulant Therapy ◽  
Venous Insufficiency ◽  
Absolute Risk ◽  
Duplex Ultrasound ◽  
Absolute Risk Reduction ◽  
Controlled Study ◽  
Compression Stocking ◽  
Catheter Directed Thrombolysis

Background: It was found that 50% of patients with iliofemoral deep venous thrombosis (DVT) treated by anticoagulant alone and compression stocking developed post thrombotic syndrome (PTS). Accelerated removal of thrombus by thrombolytic agents may increase venous patency and prevent PTS. The objective of the study was to assess short-term efficacy of additional catheter directed thrombolysis (CDT) compared with standard anticoagulant therapy alone.Methods: Prospective, randomized, controlled study on 50 patients (18–75 years) with acute iliofemoral DVT and symptoms <21 days were randomized to receive additional CDT or standard anticoagulant therapy alone. After 6 months, vein patency and insufficiency (reflux) was assessed using duplex ultrasound by an investigator blinded to previous treatments.Results: Fifty patients were allocated additional CDT (n=25) or ACs alone (n=25). After CDT, grade III (complete) lysis was achieved in 17 (68%) and grade II (50%–90%) lysis in 5 patients (20%). One patient suffered major bleeding and two had clinically relevant bleeding related to the CDT procedure. After 6 months, iliofemoral patency was found in 17 (68%) in the CDT group vs. 8 (32%) controls, corresponding to an absolute risk reduction 36% (95% CI, p=0.002). Femoral venous insufficiency was found to be higher among the ACs group 11 patients (44%) vs. 7 patients (28%) in the CDT group.Conclusions: After 6 months, additional CDT increased iliofemoral patency from 32% to 68% and decreased venous insufficiency from 44% to 28%.

Deep Vein Thrombosis Post Radiofrequency Ablation of the Saphenous and Perforator Veins: Is Duplex Ultrasound Necessary within Five Days?

2017 ◽  
Vol 41 (1) ◽  
pp. 11-12
Author(s):  
Anita Altawan ◽  
David Golchian ◽  
Mazen Bazzi ◽  
John Iljas ◽  
Bipinchandra Patel
Keyword(s):  
Deep Vein Thrombosis ◽  
Radiofrequency Ablation ◽  
Venous Thrombosis ◽  
Radio Frequency ◽  
Deep Venous Thrombosis ◽  
Venous Insufficiency ◽  
Duplex Ultrasound ◽  
Vein Thrombosis ◽  
Post Procedure ◽  
Deep Vein

Radiofrequency ablation (RFA) of the saphenous and perforator veins (“closure”) is a relatively newer option for treatment of venous insufficiency patients. A known complication of the RFA is deep vein thrombosis also known as DVT. The purpose of this study is to demonstrate the probability of acute deep venous thrombosis post radio-frequency vein ablation. This research also helped determine medical necessity of a postoperative venous duplex examination within 5 days post-procedure.

scholarly journals Bullous erythema nodosum leprosum: a rare case series

2019 ◽  
Vol 90 (4) ◽  
pp. 469-475
Author(s):  
Swetalina Pradhan ◽  
Arpita Nibedita Rout ◽  
Chandra Sekhar Sirka ◽  
Kananbala Sahu ◽  
Gaurav Dash
Keyword(s):  
Rare Case ◽  
Erythema Nodosum ◽  
Case Series ◽  
Erythema Nodosum Leprosum

scholarly journals Subutex® Abuse Presenting to the Emergency Department: A Case Series

2007 ◽  
Vol 14 (3) ◽  
pp. 163-168
Author(s):  
HC Chew
Keyword(s):  
Emergency Department ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Epidural Abscess ◽  
Public Awareness ◽  
Case Series ◽  
Opiate Withdrawal ◽  
Limb Ischaemia ◽  
Sublingual Buprenorphine ◽  
High Index Of Suspicion

Introduction Subutex® (sublingual buprenorphine hydrochloride) tablets are prescribed to alleviate symptoms of opiate withdrawal in addicts undergoing a cessation programme. Although Subutex® is safe and effective, parenteral abuse is an emerging phenomenon. A variety of complications may present due to the different areas that patients inject themselves. Aim We present a case series of four patients who presented to the emergency department following complications of Subutex® abuse. The complications included deep venous thrombosis, limb ischaemia and epidural abscess with osteomyelitis of the spine. Discussion Sublingual buprenorphine was launched in Singapore in 2002. It is currently the preferred alternative to methadone for treating opiate dependency locally. Despite safeguards, instances of abuse of buprenorphine exist. These medications can be passed or sold to others not on a cessation programme. Two of the 4 patients in this series obtained Subutex® illegally. Parenteral abuse of Subutex® is of grave concern. In Australia and France, between 23–37% of Subutex® users have abused it in this fashion. Conclusion Subutex® abuse is not uncommon in Singapore. Complications especially from parenteral use can occur and may result in serious morbidity. A high index of suspicion among physicians must be maintained in patients with unusual limb infections, ischaemia or venous thrombosis. Tighter regulations on prescription and consumption of Subutex® may be useful in preventing these complications, in addition to increasing public awareness and education of the risks of parenteral abuse for patients on cessation programme.

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