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[A young patient with multiple arterial occlusions]

C Panzere1, A Brieke, B Bräuer

  • 1Medizinische Abteilung für Endokrinologie, Stoffwechsel Und Angiologie, Städtisches Krankenhaus München-neuperlach.

Medizinische Klinik (Munich, Germany : 1983)
|June 19, 1998
PubMed
Summary

Mild hyperhomocysteinemia is a significant risk factor for premature arterial occlusive disease. This case highlights its role in a young female with multiple arterial occlusions, emphasizing the need for considering this condition in diagnosis.

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Area of Science:

  • Vascular Medicine
  • Cardiovascular Disease
  • Metabolic Disorders

Background:

  • Mild hyperhomocysteinemia, stemming from genetic or nutritional factors, is a recognized independent risk factor for premature arterial occlusive disease.
  • Arterial occlusive disease can manifest in various vascular beds, impacting organs such as the intestines and extremities.

Observation:

  • A 27-year-old female presented with symptoms of acute limb ischemia and a history of recurrent small bowel ileus.
  • Angiography identified occlusions in the popliteal artery, superior mesenteric artery, and celiac trunk.
  • Patient risk factors included smoking, oral contraceptive use, and elevated homocysteine levels.

Findings:

  • Conservative treatment with prostaglandins and physical therapy was initiated.

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  • Oral supplementation with folate and B vitamins normalized homocysteine levels after 4 weeks.
  • No genetic defect in homocysteine metabolism enzymes was identified.

    • Implications:

    • This case underscores the importance of considering mild hyperhomocysteinemia in the differential diagnosis of premature arterial occlusive disease, even in young patients.
    • Effective management of hyperhomocysteinemia through vitamin supplementation can potentially mitigate vascular risks.
    • Further investigation into non-genetic causes of hyperhomocysteinemia is warranted in such cases.