A case of acute pulmonary embolism associated with dysplasminogenemia

J Korean Med Sci. 2013 Jun;28(6):959-61. doi: 10.3346/jkms.2013.28.6.959. Epub 2013 Jun 3.

Abstract

The incidence of pulmonary embolism (PE) rises markedly with age, and only a few cases have been reported in younger adults. Thrombophilia has been reported as one of the predisposing factors for PE in younger adults. Here we report an extraordinary case of PE complicated with dysplasminogenemia, a rare genetic disorder resulting in hypercoagulability, in a young male. An 18-yr-old male visited an emergency room in the United States complaining chest discomfort. He was diagnosed as PE with deep vein thrombosis without apparent risk factors. Anticoagulation therapy with warfarin had been initiated and discontinued after 6 months of treatment. After returning to Korea he was tested for thrombophilia which revealed decreased activity of plasminogen and subsequent analysis of PLG gene showed heterozygous Ala620Thr mutation. He was diagnosed with PE complicated with dysplasminogenemia. Life-long anticoagulation therapy was initiated. He is currently under follow-up without clinical events for 2 yr.

Keywords: Deficiency; Diagnosis; Plasminogen; Pulmonary Embolism; Venous Thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adolescent
  • Anticoagulants / therapeutic use
  • Conjunctivitis / complications
  • Conjunctivitis / diagnosis*
  • Heterozygote
  • Humans
  • Male
  • Plasminogen / deficiency*
  • Plasminogen / genetics
  • Polymorphism, Single Nucleotide
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology
  • Risk Factors
  • Skin Diseases, Genetic / complications
  • Skin Diseases, Genetic / diagnosis*
  • Tomography, X-Ray Computed
  • Venous Thrombosis / etiology
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Warfarin
  • Plasminogen

Supplementary concepts

  • Plasminogen Deficiency, Type I