[Prevalence and etiological profiles of atypical localization venous thrombosis : A descriptive multicenter study]

Abstract

Introduction: Venous thrombosis of unusual sites is much rarer than in the lower limbs and requires a rigorous etiological approach. The objective was to describe the clinical and progressive peculiarities of unusual localization venous thrombosis as well as their etiologies.

Patients and methods: Multicenter descriptive retrospective study of hospitalized patient records in the two large Hospital Centers, Antananarivo, Madagascar between 2017 and 2020 in which the diagnosis of unusual venous thrombosis was confirmed by imaging.

Results: Seventy-seven thrombosis of atypical localization were present in fifty-nine patients identified. These were 24 men and 35 women with an M/F sex ratio of 0.68. The mean age of our patients was 49.4 years (± 16.76). Thrombosis seated in the majority of cases in the portal veins (n ​​= 27), cerebral veins (n ​​= 20), vena cava (n = 10), splenic veins (n ​​= 5), upper limbs and splenomearic trunk (each n = 4), Renal vein (n = 3). Venous thrombosis had occurred following tobacco intoxication (n = 15 cases); bed rest (n = 10); surgical intervention (n = 4). The aetiological assessment revealed a neoplastic origin in 27 cases (45.77%) dominated by hepatocellular carcinoma (n = 13). the antiphospholipid antibody syndrome dominates the case of autoimmune causes (n = 4). In terms of mortality, there were no deaths during the initial hospitalization. Eight patients had died, 4 of them due to hepatocellular carcinoma, 2 after surgery, and 1 each due to kidney cancer and liver cirrhosis. The mean follow-up period was 34.03 ± 51.5 days.

Conclusion: Unusual thrombosis, although rare, constitute a real challenge in the etiological approach. In clinical practice, the description of these thrombosis would allow us to understand their pathophysiological mechanism in order to plan the best management.

Keywords: Antiphospholid syndrome, Thrombophilia; Deep veinous thrombosis; Madagascar; Neoplasms; Thrombose veineuse profonde; néoplasme; syndrome des antiphospholipides; thrombophilie.