Korean J Intern Med.  2006 Dec;21(4):244-247. 10.3904/kjim.2006.21.4.244.

Extensive venous thrombosis of the upper extremity in a diabetic patient with a hyperosmolar hyperglycemic state

• Park J
• Kim DJ
• Kim HY
• Seo JA
• Kim SG
• Baik SH
• Choi DS

• KMID: 759859
• DOI: http://doi.org/10.3904/kjim.2006.21.4.244

Abstract

We report a case of extensive venous thrombosis of the upper extremity in a patient with a hyperosmolar hyperglycemic state (HHS). Thrombosis of the upper extremities is generally found in 4% of cases with deep venous thrombosis. Extensive, symptomatic venous thrombosis of the upper extremity, as seen in this patient, is rare except with catheter-related thrombosis. Recent studies have supported the safety and efficacy of catheter-directed thrombolysis in patients with no contraindication to thrombolytic therapy, and have recommended early catheter-directed thrombolysis. Therefore, our patient was treated with early catheter-directed thrombolysis followed by anticoagulation.

Keyword

Hyperglycemic Hyperosmolar Nonketotic Coma; Diabetes Mellitus; Upper Extremity; Venous Thrombosis

MeSH Terms

Venous Thrombosis/diagnosis/drug therapy/*etiology
Ultrasonography, Doppler
Thrombolytic Therapy/methods
*Subclavian Vein
Phlebography
Male
Insulin/administration & dosage/therapeutic use
Injections, Intravenous
Hypoglycemic Agents/administration & dosage/therapeutic use
Hyperglycemic Hyperosmolar Nonketotic Coma/*complications/drug therapy
Humans
Diagnosis, Differential
Catheterization, Peripheral/*adverse effects
*Brachiocephalic Veins
*Axillary Vein
Anticoagulants/administration & dosage/therapeutic use
Adult