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Plantar Vein Thrombosis in a Patient with Hyperhomocysteinemia: A Case Report

Thomas Saliba1, Charlotte Wynants1, Dominique Pottier1

  • 1*Department of Radiology, Hôpital de Braine L'Alleud, Braine L'Alleud, Belgium.

Journal of the American Podiatric Medical Association
|October 30, 2025
PubMed

Insights

Hyperhomocysteinemia (HHcy) can lead to rare blood clots in unusual places, like the foot veins. This case highlights the need for awareness of HHcy

Area of Science:

  • Vascular Medicine
  • Metabolic Disorders
  • Case Reports

Background:

  • Hyperhomocysteinemia (HHcy) is associated with increased risk of arterial cardiovascular events, neuropsychiatric illness, bone health issues, and venous thrombosis.
  • Venous thromboembolism (VTE) in HHcy patients typically occurs in common locations, but atypical presentations are increasingly recognized.

Purpose of the Study:

  • To report a rare case of plantar metatarsal vein thrombosis in a patient with HHcy.
  • To emphasize the importance of considering VTE in unusual anatomical locations in HHcy patients presenting with pain.

Main Methods:

  • A case presentation of a 45-year-old woman diagnosed with HHcy.
  • Diagnostic ultrasound to identify plantar metatarsal vein thrombosis.

Main Results:

  • The patient presented with acute foot pain and a history of recurrent superficial venous thrombosis.
  • Ultrasound confirmed plantar metatarsal vein thrombosis, a rare event with fewer than 50 reported cases.
  • No prior literature linked plantar vein thrombosis directly to HHcy.

Conclusions:

  • This case highlights a rare thromboembolic event in an unusual location associated with HHcy.
  • Clinicians should maintain a high index of suspicion for VTE in atypical sites in HHcy patients, even without other major risk factors.
  • Awareness of HHcy's association with thrombosis in unusual anatomical locations is crucial for timely diagnosis and management.

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