Inferior vena cava thrombosis attributable to hyperhomocysteinemia: A case report from Nepal

Inferior vena cava thrombosis (IVCT) is a rare complication of deep vein thrombosis (DVT) in the legs. The etiology of IVC thrombosis can be divided into genetic versus nongenetic (environmental/acquired) etiological factors found in Virchow's triad of stasis, endothelial injury, and hypercoagulability. Hyperhomocysteinemia is a rare risk factor for venous thromboembolism and atherosclerotic disease. Hence, very few cases have been described to date to knowledge. A case of a 78‐year‐old hypertensive man who presented with hyperhomocysteinemia‐induced DVT of the left leg extending toward an anatomically normal IVC is discussed in the report. Patients with deep vein thrombosis should undergo a comprehensive hypercoagulable workup, including homocysteine level along with all thrombophilia screening, before initiating anticoagulant therapy. Abdominal and chest imaging should be performed to look out for thrombus extension. Early detection and management are crucial to the survival of patients.