Mondor's Disease in SARS-CoV-2 Infection: A Case of Superficial Vein Thrombosis in the Era of COVID-19

SARS-CoV-2 causes blood hypercoagulability and severe inflammation resulting in an increased risk of thrombosis. Consequently, COVID-19 patients with cardiovascular disease seem to be at higher risk of adverse events. Mondor’s disease is a rare, generally self-limiting, thrombosis of the penis. The pathogenesis of Mondor’s disease is unknown, and it is usually diagnosed through clinical signs and with Doppler ultrasound evaluation. We describe the case of a young man with COVID-19 infection who manifested Mondor’s disease.

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Increased risk of venous thrombosis in persons with clinically diagnosed superficial vein thrombosis: results from the MEGA study

Blood ◽

10.1182/blood-2011-05-356071 ◽

2011 ◽

Vol 118 (15) ◽

pp. 4239-4241 ◽

Cited By ~ 28

Author(s):

Kirsten van Langevelde ◽

Willem M. Lijfering ◽

Frits R. Rosendaal ◽

Suzanne C. Cannegieter

Keyword(s):

Venous Thrombosis ◽

Factor V Leiden ◽

Population Based ◽

Factor V ◽

Superficial Vein ◽

Vein Thrombosis ◽

Increased Risk ◽

Superficial Vein Thrombosis ◽

History Of ◽

Deep Vein

Abstract Superficial vein thrombosis (SVT) is regarded a self-limiting disorder, although the authors of recent studies showed that ultrasonographically diagnosed SVT is a precursor for venous thrombosis. We aimed to determine whether the same holds true for clinically diagnosed SVT and to what extent it is associated with thrombophilia in a population-based case-control study (ie, Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis). We found that a history of clinical SVT was associated with a 6.3-fold (95% confidence interval [CI] 5.0-8.0) increased risk of deep-vein thrombosis and a 3.9-fold (95% CI 3.0-5.1) increased risk of pulmonary embolism. Blood group non-O and factor V Leiden showed a small increase in SVT risk in controls, with odds ratios of 1.3 (95% CI 0.9-2.0) and 1.5 (95% CI 0.7-3.3), respectively. In conclusion, clinically diagnosed SVT was a risk factor for venous thrombosis. Given that thrombophilia was only weakly associated with SVT, it is likely that other factors (varicosis, obesity, stasis) also play a role in its etiology.

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The risk of subsequent cancer and arterial cardiovascular events in patients with superficial vein thrombosis in the legs

Blood ◽

10.1182/blood-2011-06-364232 ◽

2011 ◽

Vol 118 (17) ◽

pp. 4719-4722 ◽

Cited By ~ 16

Author(s):

Paolo Prandoni ◽

Edoardo Casiglia ◽

Valerie Tikhonoff ◽

Alain Leizorovicz ◽

Hervé Decousus ◽

...

Keyword(s):

Confidence Interval ◽

Cardiovascular Events ◽

Hazard Ratio ◽

Superficial Vein ◽

Vein Thrombosis ◽

Increased Risk ◽

Superficial Vein Thrombosis ◽

Event Rates ◽

Deep Vein

Abstract Although it has been clearly demonstrated that venous thromboembolism is associated with an increased risk of subsequent overt cancer and arterial cardiovascular events in comparison with control populations, whether this association also applies to patients with isolated (ie, without concomitant involvement of the deep vein system) superficial vein thrombosis (SVT) in the legs is unknown. In 737 consecutive patients with isolated SVT not involving the sapheno-femoral junction, we conducted a retrospective investigation to assess the rate of cancer and that of arterial cardiovascular events occurring during follow-up. The event rates were compared with those occurring in 1438 controls having comparable characteristics. Both cases and controls were followed-up for an average period of 26 ± 8 months (range, 3-45). Malignancy was diagnosed in 26 cases (3.5%) and 56 controls (3.9%), leading to a hazard ratio of 0.86 (95% confidence interval, 0.55%-1.35%). Arterial cardiovascular events occurred in 32 cases (4.3%) and 63 controls (4.4%), leading to a hazard ratio of 0.97 (95% confidence interval, 0.63%-1.50%). We conclude that the occurrence of isolated SVT in the legs does not place patients at an increased risk of malignancies or arterial cardiovascular events. Whether this conclusion also applies to patients whose thrombosis involves the sapheno-femoral junction remains to be demonstrated.

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Genetic Risk Factors for Superficial Vein Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0037-1614362 ◽

1999 ◽

Vol 82 (10) ◽

pp. 1215-1217 ◽

Cited By ~ 79

Author(s):

Marco Cattaneo ◽

Emanuela Taioli ◽

Valerio De Stefano ◽

Patrizia Chiusolo ◽

Pier Mannuccio Mannucci ◽

...

Keyword(s):

Risk Factors ◽

First Episode ◽

Factor V ◽

Superficial Vein ◽

Vein Thrombosis ◽

Naturally Occurring ◽

G20210a Mutation ◽

Increased Risk ◽

Superficial Vein Thrombosis ◽

Prothrombin Mutation

SummaryInherited thrombophilic states are associated with an increased risk for deep vein thrombosis (DVT), but whether they are also risk factors for superficial vein thrombosis (SVT) is uncertain. We assessed the risk conferred by inherited thrombophilic states in patients with a first episode of SVT in whom the coexistence of DVT had been ruled out by ultrasonography. Sixty-three patients with SVT, after exclusion of patients with varicose veins, malignant or autoimmune disease, and 537 healthy individuals were investigated. The G1691A mutation in the factor V gene, the G20210A mutation in the prothrombin gene, and deficiencies of the naturally occurring inhibitors of coagulation (antithrombin, protein C, protein S) were searched. The prevalence of each thrombophilic state was higher in patients than in controls. The odds ratios for SVT were 6.1 (95% confidence interval [CI], 2.6 to 14.2) in patients with the G1691A factor V mutation, 4.3 (95% CI, 1.5 to 12.6) in those with the G20210A prothrombin mutation, and 12.9 (95% CI, 3.6 to 46.2) in those with deficiencies of the naturally occurring inhibitors of coagulation taken together. Risks did not substantially change when the analysis was restricted to 43 patients who had SVT as their only thrombotic manifestation, being 4.3 (95% CI, 1.5 to 12.3) in patients with factor V mutation, and 3.6 (95% CI, 1.0 to 13.1) in those with the prothrombin mutation. Among the circumstantial risk factors investigated (surgery, trauma, prolonged immobilization, oral contraceptives and pregnancy or puerperium), pregnancy or puerperium was the most frequently associated with SVT, being present in 38% of women. Our findings indicate that inherited thrombophilic states are associated with an increased risk for SVT. Hence, a laboratory search of these alterations is recommended in patients with SVT, because it allows the identification of patients at high risk of DVT in whom antithrombotic prophylaxis is particularly warranted.

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Prognostic significance of concomitant superficial vein thrombosis in patients with deep vein thrombosis of the lower limbs

Thrombosis and Haemostasis ◽

10.1055/a-1414-5055 ◽

2021 ◽

Author(s):

Álvaro Dubois-Silva ◽

Cristina Barbagelata-López ◽

Patricia Piñeiro-Parga ◽

Iria Francisco ◽

Conxita Falgà ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Major Bleeding ◽

Lower Limb ◽

Prognostic Significance ◽

Superficial Vein ◽

Vein Thrombosis ◽

Increased Risk ◽

Superficial Vein Thrombosis ◽

Deep Vein

Background: The prognostic significance of concomitant superficial vein thrombosis (SVT) in patients with lower-limb deep vein thrombosis (DVT) has not been consistently evaluated. Methods: We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to compare the rates of subsequent PE, recurrent DVT, major bleeding or death in patients with lower-limb DVT, according to the presence or absence of concomitant SVT. Results: Since March 2015 to May 2020, there were 8,743 patients with lower-limb DVT. Of these, 745 (8.5%) had concomitant SVT. Most patients (97.4% in both subgroups) received anticoagulant therapy (median duration, 138 vs. 147 days). During follow-up (median, 193 vs. 210 days), 156 (1.8%) patients developed subsequent PE, 336 (3.8%) had recurrent DVT, 201 (2.3%) had major bleeding and 844 (9.7%) died. Patients with concomitant SVT had a higher rate of subsequent PE (rate ratio [RR]: 2.11; 95%CI: 1.33-3.24) than those with isolated DVT, with no significant differences in the rates of recurrent DVT (RR: 0.80; 95%CI: 0.50-1.21), major bleeding (RR: 0.77; 95%CI: 0.41-1.33) or death (RR: 0.81; 95%CI: 0.61-1.06). On multivariable analysis, patients with DVT and SVT concomitantly were at increased risk for subsequent PE during anticoagulation (adjusted hazard ratio [HR]: 2.23; 95%CI: 1.22-4.05) and also during the entire follow-up period (adjusted HR: 2.33; 95%CI: 1.49-3.66). Conclusion: Patients with lower-limb DVT and SVT concomitantly are at increased risk to develop PE. Further studies are needed to externally validate our findings and to determine if these patients could benefit from a different management strategy.

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