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Phlegmasia cerulea dolens and its association with hypercoagulable states: case reports
D J Cohen1, R Briggs, H D Head
1Cardiothoracic Surgery Service, Brooke Army Medical Center, Ft. Sam Houston, Texas.
Insights
Phlegmasia cerulea dolens is a severe condition linked to hypercoagulable states. Early diagnosis and management of these underlying clotting disorders are crucial for patient outcomes.
Area of Science:
- Vascular Medicine
- Hematology
Background:
- Phlegmasia cerulea dolens is a rare, severe venous thromboembolism.
- Associated hypercoagulable states are often undiagnosed.
Observation:
- Six patients with phlegmasia cerulea dolens were studied.
- Hypercoagulable states identified included heparin-induced thrombocytopenia, protein C deficiency, and antithrombin III deficiency.
Findings:
- A strong correlation exists between phlegmasia cerulea dolens and underlying hypercoagulable states.
- Diagnostic advancements are key to identifying these associations.
Implications:
- Recognizing hypercoagulable states is vital for managing phlegmasia cerulea dolens.
- Prophylaxis and treatment strategies should target these underlying conditions.
- Improved diagnostic techniques enhance patient care for this limb- and life-threatening complication.
Abstract:
Six patients who developed phlegmasia cerulea dolens are described. All patients had associated hypercoagulable states: heparin-induced thrombocytopenia (2 patients), congenital deficiency of protein C (1 patient), and antithrombin III deficiency (3 patients). Their clinical course and management are discussed. Previous reports have failed to show a definite correlation between phlegmasia cerulea dolens and hypercoagulable states because of an unavailability of appropriate diagnostic techniques. Phlegmasia cerulea dolens is a life- and limb-threatening complication. An appreciation of underlying hypercoagulable states is essential to proper management, prophylaxis, and treatment of this disorder.