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Related Experiment Videos

Hyperhomocysteinemia masquerading as pulmonary embolism.

S I Dani1, S Thanvi, J M Shah

  • 1UN Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Ahmedabad 380016 (Gujarat).

The Journal of the Association of Physicians of India
|January 9, 2004
PubMed
Summary

A case study reveals vitamin B12 deficiency causing megaloblastic anemia and hyperhomocysteinemia, leading to deep vein thrombosis and pulmonary embolism. This rare association highlights a novel cause for recurrent venous thromboembolism.

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Area of Science:

  • Cardiology
  • Hematology
  • Internal Medicine

Background:

  • Deep vein thrombosis (DVT) and pulmonary embolism (PE) are significant causes of morbidity and mortality.
  • Hyperhomocysteinemia is a known risk factor for venous thromboembolism.
  • Vitamin B12 deficiency can lead to megaloblastic anemia and elevated homocysteine levels.

Observation:

  • A 30-year-old male presented with acute symptoms suggestive of pulmonary embolism, including breathlessness and tachycardia.
  • Physical examination revealed jugular venous distension with clear lungs.
  • Diagnostic workup showed normal chest X-ray, ECG findings of right ventricular strain, and echocardiographic evidence of right heart strain and pulmonary hypertension.

Findings:

  • Doppler confirmed deep venous system thrombosis.

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  • Routine investigations for DVT etiology were normal except for significantly elevated serum homocysteine.
  • Megaloblastic anemia and vitamin B12 deficiency were identified as the underlying cause of hyperhomocysteinemia.
  • Implications:

    • This case highlights a rare but significant association between vitamin B12 deficiency, hyperhomocysteinemia, and recurrent DVT/PE.
    • Early identification and management of vitamin B12 deficiency may prevent life-threatening thromboembolic events.
    • Clinicians should consider vitamin B12 deficiency in the etiology of unexplained hyperhomocysteinemia and recurrent venous thromboembolism.