Tuberc Respir Dis.  2008 Jun;64(6):460-465.

Two Cases of Pulmonary Thromboembolism in Young Patients with Hyperhomocysteinemia

• Lee WH
• Park CH
• Ko HY
• An HJ
• Kwon SS
• Kim YH

Abstract

Incidences of pulmonary thromboembolism markedly increase with age. Risk factors of pulmonary thromboembolism are surgery, trauma, acute medical illness, immobilization, pregnancy, usage of hormone, and advanced age. In the cases of thrombomembolism occurred in young age, the possibility of thrombophilc state is needed to be investigated. Among many diseases or state associated thrombophilic state, homocyteinemia should be considered a cause of thromboembolism before fifth decade. Homocyteinemia is caused by deficiency of N-5-methyltetrahydrofolate, cystathionie beta-synthase and vitamin B12. The presence of the mutation of 5,10-methyleneterahydrofolate lead to homocyteinemia by deficiency of N-5-methyltetrahydrofolate. Homocysteine is acknowledged the risk factor of cardiovascular event, and storke. Homocysteinemia can be the cause of thromboemboism via damaging endotheial cell. We present two cases of pulmonary thromboembolism in young age which seem to be associated with homocysteinemia precipitated by mutation of 5,10-methyleneterahydrofolate.

Keyword

Pulmonary thromboembolism; Homocysteine; 5,10-methyleneterahydrofolate reductase; Young age

MeSH Terms

Homocysteine
Humans
Hyperhomocysteinemia
Immobilization
Incidence
Pregnancy
Pulmonary Embolism
Risk Factors
Thromboembolism
Vitamin B 12
Homocysteine
Hyperhomocysteinemia
Vitamin B 12

Figure

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  Figure 1 Chest CT scan shows a low density in left lower lobe of lung (A), and a perfusion defect in left pulmonary artery (B).

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  Figure 2 Doppler sonography shows echogenic lesions in left popliteal vein (A, B) and left femoral vein (C, D).

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  Figure 3 Abdomen CT scan shows a focal defect in right common iliac artery.

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  Figure 4 Chest CT scan shows low density thromboemboli seen in the lateral aspect of the right lower lobar artery (A), left lower lobar superior and posterolateral basal segmental arteries (B).

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  Figure 5 Metabolism of homocysteine.

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