[논문]Lemierre Syndrome in Adolescent with Active Ulcerative Colitis

Unic, Josipa; Kovacic, Matea; Jakovljevic, Gordana; Batos, Ana Tripalo; Grmoja, Tonci; Hojsak, Iva

doi:10.5223/pghn.2018.21.3.214

Lemierre Syndrome in Adolescent with Active Ulcerative Colitis 원문보기

Pediatric gastroenterology, hepatology & nutrition, v.21 no.3, 2018년, pp.214 - 217

Unic, Josipa (University of Zagreb School of Medicine, Children's Hospital Zagreb) , Kovacic, Matea (University of Zagreb School of Medicine, Children's Hospital Zagreb) , Jakovljevic, Gordana (Department of Oncology, Children's Hospital Zagreb) , Batos, Ana Tripalo (Department of Pediatric Radiology, Children's Hospital Zagreb) , Grmoja, Tonci (Department of Pediatric Radiology, Children's Hospital Zagreb) , Hojsak, Iva (University of Zagreb School of Medicine, Children's Hospital Zagreb)

Abstract ▼ AI-Helper

Inflammatory bowel disease (IBD) is a well-recognized risk factor for thrombotic events in adults but data on children are scarce. In the great majority of adult patients, thrombotic events are usually deep vein thrombosis and pulmonary embolism. Other sites such as jugular veins are extremely rare. We present a case of Lemierre syndrome in an adolescent girl with active ulcerative colitis and discuss possible risk factors. This is the first reported case of severe Lemierre syndrome with thrombus extension to cranial veins in a patient with ulcerative colitis. Early recognition of Lemierre syndrome in patients who present with rapidly worsening symptoms of neck pain, fever and signs of pharyngitis is imperative because it increases a chance of favorable prognosis. It is important for pediatricians treating IBD patients not to underestimate possible thrombotic events in children with IBD. Recognition of additional risk factors is crucial for prompt diagnosis and adequate treatment.

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She became afebrile after 72 hours of antibiotic treatment. She underwent comprehensive thrombophilia testing; factor V Leiden, protein C and S, factor VIII, and antithrombin III were found to be normal, antinuclear antibodies and anticardiolipin antibodies were negative and homocysteine levels were normal. Furthermore, F2 gene mutation G20210A c.

대상 데이터

A 17-year-old girl was admitted to a tertiary medical pediatric gastroenterology unit due to abdominal pain, fever, severe sideropenic anemia (hemoglobin level of 70 g/L and a ferritin value of 9 μg/L) and diarrhea.

참고문헌 (12)

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3 Alperstein A Fertig RM Feldman M Watford D Nystrom S Delva G Septic thrombophlebitis of the internal jugular vein, a case of Lemierre's syndrome Intractable Rare Dis Res 2017 6 137 140 28580216
4 Cupit-Link MC Nageswara Rao A Warad DM Rodriguez V Lemierre syndrome: a retrospective study of the role of anticoagulation and thrombosis outcomes Acta Haematol 2017 137 59 65 28006761

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5 Lazzerini M Bramuzzo M Maschio M Martelossi S Ventura A Thromboembolism in pediatric inflammatory bowel disease: systematic review Inflamm Bowel Dis 2011 17 2174 2183 21910180
6 Alkim H Koksal AR Boga S Sen I Alkim C Etiopathogenesis, prevention, and treatment of thromboembolism in inflammatory bowel disease Clin Appl Thromb Hemost 2017 23 501 510 26893444

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7 Van Assche G Dignass A Bokemeyer B Danese S Gionchetti P Moser G Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 3: special situations J Crohns Colitis 2013 7 1 33 23040453
8 Danese S Papa A Saibeni S Repici A Malesci A Vecchi M Inflammation and coagulation in inflammatory bowel disease: The clot thickens Am J Gastroenterol 2007 102 174 186 17100967

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9 Habek M Petravić D Ozretić D Brinar VV Horner syndrome due to jugular vein thrombosis (Lemierre syndrome) J Neurol Neurosurg Psychiatry 2008 79 293 18281447
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11 Armstrong AW Spooner K Sanders JW Lemierre's syndrome Curr Infect Dis Rep 2000 2 168 173 11095853

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12 Lu MD Vasavada Z Tanner C Lemierre syndrome following oropharyngeal infection: a case series J Am Board Fam Med 2009 22 79 83 19124638

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DOI : 10.5223/pghn.2018.21.3.214 [무료]
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