[Paget-Schroetter síndrome associated with hyperhomocsyteinemia]

Venous thromboembolic disease (VTED) in the upper extremities is an infrequent entity, although its incidence has increased in relation to the use of central venous catheters. Its etiology can be primary (idiopathic, spontaneous, due to effort or traumatic) or secondary (related to tumours, central venous catheters, etc.). We present a case of primary venous thrombosis of the upper right extremity, also called the Paget-Schroetter syndrome. This clinical picture is usually associated with intensive and/or repetitive exercise or effort of the affected extremity, anatomical alterations in the zone, or it can be the first manifestation of a previously unknown thrombophilic state, as in the case that concerns us. The clinical picture usually consists of pain in the affected extremity, frequently accompanied by edema and collateral circulation. Echography-Doppler frequently presents false negatives, and it is recommendable to carry out CAT, due to its greater specificity and for evaluating the neighbouring structures, although flebography continues to be the cardinal test for diagnosing this picture. There is no unanimity of opinion concerning treatment, and it is recommendable that this should be individualised in accordance with the characteristics of each case.