Multiple Thrombi in the Heart in Trousseau Syndrome Caused by Pancreatic Carcinoma
A 65-year-old woman presented to our emergency room because of sudden onset of right hemiparesis with severe fatigue. Neurological examination revealed right hemiparesis with right facial numbness and an extensor planter response on the right side.Magnetic resonance imaging with diffusion-weighted i...
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| Veröffentlicht in: | Journal of stroke and cerebrovascular diseases 2018-05, Vol.27 (5), p.e75-e77 |
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| container_title | Journal of stroke and cerebrovascular diseases |
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| creator | Takeshita, Sho Ogata, Toshiyasu Mera, Hidekazu Tsugawa, Jun Aoki, Mikiko Takeshita, Morishige Tsuboi, Yoshio |
| description | A 65-year-old woman presented to our emergency room because of sudden onset of right hemiparesis with severe fatigue. Neurological examination revealed right hemiparesis with right facial numbness and an extensor planter response on the right side.Magnetic resonance imaging with diffusion-weighted imaging revealed multiple highintensity areas in both cerebral hemispheres and the right cerebellum. A diagnosis of acute stage of multiple brain infarctions caused by emboli was made. An abdominal computed tomography showed a pancreatic tumor with multiple liver metastases. High D-dimer and serum carbohydrate antigen 19-9 concentration strongly suggested Trousseau syndrome associated with pancreatic cancer. The patient had another large embolic stroke and died on day 47. Autopsy was performed. There were large thrombi in the left ventricular apex and in the left atrial appendage There was also a papillary-shaped vegetation on the aortic valve that consisted mainly of fibrin without any inflammatory cells or destruction of the valve, these findings being characteristic of NBTE. This case is remarkable in that the patient had 3 different types of cardiac thrombi in her heart associated with Trousseau syndrome. |
| doi_str_mv | 10.1016/j.jstrokecerebrovasdis.2017.12.005 |
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Neurological examination revealed right hemiparesis with right facial numbness and an extensor planter response on the right side.Magnetic resonance imaging with diffusion-weighted imaging revealed multiple highintensity areas in both cerebral hemispheres and the right cerebellum. A diagnosis of acute stage of multiple brain infarctions caused by emboli was made. An abdominal computed tomography showed a pancreatic tumor with multiple liver metastases. High D-dimer and serum carbohydrate antigen 19-9 concentration strongly suggested Trousseau syndrome associated with pancreatic cancer. The patient had another large embolic stroke and died on day 47. Autopsy was performed. There were large thrombi in the left ventricular apex and in the left atrial appendage There was also a papillary-shaped vegetation on the aortic valve that consisted mainly of fibrin without any inflammatory cells or destruction of the valve, these findings being characteristic of NBTE. This case is remarkable in that the patient had 3 different types of cardiac thrombi in her heart associated with Trousseau syndrome.</description><identifier>ISSN: 1052-3057</identifier><identifier>EISSN: 1532-8511</identifier><identifier>DOI: 10.1016/j.jstrokecerebrovasdis.2017.12.005</identifier><identifier>PMID: 29503168</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Autopsy ; Blood Coagulation ; Brain Infarction - diagnostic imaging ; Brain Infarction - etiology ; CA-19-9 Antigen - blood ; Carcinoma - blood ; Carcinoma - complications ; Carcinoma - diagnostic imaging ; Carcinoma - secondary ; cerebral infarction ; Diffusion Magnetic Resonance Imaging ; Endocarditis, Non-Infective - blood ; Endocarditis, Non-Infective - diagnostic imaging ; Endocarditis, Non-Infective - etiology ; Fatal Outcome ; Female ; Fibrin Fibrinogen Degradation Products - analysis ; Heart Diseases - blood ; Heart Diseases - diagnostic imaging ; Heart Diseases - etiology ; Humans ; Intracranial Embolism - diagnostic imaging ; Intracranial Embolism - etiology ; Liver Neoplasms - secondary ; Nonbacterial thrombotic endocarditis ; pancreatic cancer ; Pancreatic Neoplasms - blood ; Pancreatic Neoplasms - complications ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatic Neoplasms - pathology ; Syndrome ; Thrombophilia - blood ; Thrombophilia - complications ; Thrombophilia - diagnosis ; Thrombosis - blood ; Thrombosis - diagnostic imaging ; Thrombosis - etiology ; Tomography, X-Ray Computed ; Trousseau syndrome</subject><ispartof>Journal of stroke and cerebrovascular diseases, 2018-05, Vol.27 (5), p.e75-e77</ispartof><rights>2018 National Stroke Association</rights><rights>Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-7b30abe83c2a9a6b6507ff75364e19fc89e99b4830a8470827d3ecc0819e589a3</citedby><cites>FETCH-LOGICAL-c404t-7b30abe83c2a9a6b6507ff75364e19fc89e99b4830a8470827d3ecc0819e589a3</cites><orcidid>0000-0002-5093-3402</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.12.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29503168$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takeshita, Sho</creatorcontrib><creatorcontrib>Ogata, Toshiyasu</creatorcontrib><creatorcontrib>Mera, Hidekazu</creatorcontrib><creatorcontrib>Tsugawa, Jun</creatorcontrib><creatorcontrib>Aoki, Mikiko</creatorcontrib><creatorcontrib>Takeshita, Morishige</creatorcontrib><creatorcontrib>Tsuboi, Yoshio</creatorcontrib><title>Multiple Thrombi in the Heart in Trousseau Syndrome Caused by Pancreatic Carcinoma</title><title>Journal of stroke and cerebrovascular diseases</title><addtitle>J Stroke Cerebrovasc Dis</addtitle><description>A 65-year-old woman presented to our emergency room because of sudden onset of right hemiparesis with severe fatigue. Neurological examination revealed right hemiparesis with right facial numbness and an extensor planter response on the right side.Magnetic resonance imaging with diffusion-weighted imaging revealed multiple highintensity areas in both cerebral hemispheres and the right cerebellum. A diagnosis of acute stage of multiple brain infarctions caused by emboli was made. An abdominal computed tomography showed a pancreatic tumor with multiple liver metastases. High D-dimer and serum carbohydrate antigen 19-9 concentration strongly suggested Trousseau syndrome associated with pancreatic cancer. The patient had another large embolic stroke and died on day 47. Autopsy was performed. There were large thrombi in the left ventricular apex and in the left atrial appendage There was also a papillary-shaped vegetation on the aortic valve that consisted mainly of fibrin without any inflammatory cells or destruction of the valve, these findings being characteristic of NBTE. This case is remarkable in that the patient had 3 different types of cardiac thrombi in her heart associated with Trousseau syndrome.</description><subject>Aged</subject><subject>Autopsy</subject><subject>Blood Coagulation</subject><subject>Brain Infarction - diagnostic imaging</subject><subject>Brain Infarction - etiology</subject><subject>CA-19-9 Antigen - blood</subject><subject>Carcinoma - blood</subject><subject>Carcinoma - complications</subject><subject>Carcinoma - diagnostic imaging</subject><subject>Carcinoma - secondary</subject><subject>cerebral infarction</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Endocarditis, Non-Infective - blood</subject><subject>Endocarditis, Non-Infective - diagnostic imaging</subject><subject>Endocarditis, Non-Infective - etiology</subject><subject>Fatal Outcome</subject><subject>Female</subject><subject>Fibrin Fibrinogen Degradation Products - analysis</subject><subject>Heart Diseases - blood</subject><subject>Heart Diseases - diagnostic imaging</subject><subject>Heart Diseases - etiology</subject><subject>Humans</subject><subject>Intracranial Embolism - diagnostic imaging</subject><subject>Intracranial Embolism - etiology</subject><subject>Liver Neoplasms - secondary</subject><subject>Nonbacterial thrombotic endocarditis</subject><subject>pancreatic cancer</subject><subject>Pancreatic Neoplasms - blood</subject><subject>Pancreatic Neoplasms - complications</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Syndrome</subject><subject>Thrombophilia - blood</subject><subject>Thrombophilia - complications</subject><subject>Thrombophilia - diagnosis</subject><subject>Thrombosis - blood</subject><subject>Thrombosis - diagnostic imaging</subject><subject>Thrombosis - etiology</subject><subject>Tomography, X-Ray Computed</subject><subject>Trousseau syndrome</subject><issn>1052-3057</issn><issn>1532-8511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkMtOwzAQRS0E4v0LKEuElDC248RZQgUUqQgEZW05zkR1yaPYSaX-Pa4KrNiw8kNH984cQq4oJBRodr1Mln5w_QcadFi6fq19ZX3CgOYJZQmA2CPHVHAWS0HpfriDYDEHkR-RE--XAJQKKQ7JESsEcJrJY_L6NDaDXTUYzReub0sb2S4aFhhNUbth-5i7fvQe9Ri9bboqMBhN9OixispN9KI741AP1oRPZ2zXt_qMHNS68Xj-fZ6S9_u7-WQaz54fHic3s9ikkA5xXnLQJUpumC50VmYC8rrOBc9SpEVtZIFFUaYyUDLNQbK84mgMSFqgkIXmp-Ryl7ty_eeIflCt9QabRncYRlbBC0guBaMBvd2hxvXeO6zVytlWu42ioLZu1VL95XabkSvKVHAbQi6--8ayxeo34kdmAGY7AMPWa4tOeWOxM1hZh2ZQVW__0_cFTu-ZBg</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Takeshita, Sho</creator><creator>Ogata, Toshiyasu</creator><creator>Mera, Hidekazu</creator><creator>Tsugawa, Jun</creator><creator>Aoki, Mikiko</creator><creator>Takeshita, Morishige</creator><creator>Tsuboi, Yoshio</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5093-3402</orcidid></search><sort><creationdate>201805</creationdate><title>Multiple Thrombi in the Heart in Trousseau Syndrome Caused by Pancreatic Carcinoma</title><author>Takeshita, Sho ; Ogata, Toshiyasu ; Mera, Hidekazu ; Tsugawa, Jun ; Aoki, Mikiko ; Takeshita, Morishige ; Tsuboi, Yoshio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-7b30abe83c2a9a6b6507ff75364e19fc89e99b4830a8470827d3ecc0819e589a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Autopsy</topic><topic>Blood Coagulation</topic><topic>Brain Infarction - diagnostic imaging</topic><topic>Brain Infarction - etiology</topic><topic>CA-19-9 Antigen - blood</topic><topic>Carcinoma - blood</topic><topic>Carcinoma - complications</topic><topic>Carcinoma - diagnostic imaging</topic><topic>Carcinoma - secondary</topic><topic>cerebral infarction</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Endocarditis, Non-Infective - blood</topic><topic>Endocarditis, Non-Infective - diagnostic imaging</topic><topic>Endocarditis, Non-Infective - etiology</topic><topic>Fatal Outcome</topic><topic>Female</topic><topic>Fibrin Fibrinogen Degradation Products - analysis</topic><topic>Heart Diseases - blood</topic><topic>Heart Diseases - diagnostic imaging</topic><topic>Heart Diseases - etiology</topic><topic>Humans</topic><topic>Intracranial Embolism - diagnostic imaging</topic><topic>Intracranial Embolism - etiology</topic><topic>Liver Neoplasms - secondary</topic><topic>Nonbacterial thrombotic endocarditis</topic><topic>pancreatic cancer</topic><topic>Pancreatic Neoplasms - blood</topic><topic>Pancreatic Neoplasms - complications</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Syndrome</topic><topic>Thrombophilia - blood</topic><topic>Thrombophilia - complications</topic><topic>Thrombophilia - diagnosis</topic><topic>Thrombosis - blood</topic><topic>Thrombosis - diagnostic imaging</topic><topic>Thrombosis - etiology</topic><topic>Tomography, X-Ray Computed</topic><topic>Trousseau syndrome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takeshita, Sho</creatorcontrib><creatorcontrib>Ogata, Toshiyasu</creatorcontrib><creatorcontrib>Mera, Hidekazu</creatorcontrib><creatorcontrib>Tsugawa, Jun</creatorcontrib><creatorcontrib>Aoki, Mikiko</creatorcontrib><creatorcontrib>Takeshita, Morishige</creatorcontrib><creatorcontrib>Tsuboi, Yoshio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of stroke and cerebrovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takeshita, Sho</au><au>Ogata, Toshiyasu</au><au>Mera, Hidekazu</au><au>Tsugawa, Jun</au><au>Aoki, Mikiko</au><au>Takeshita, Morishige</au><au>Tsuboi, Yoshio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiple Thrombi in the Heart in Trousseau Syndrome Caused by Pancreatic Carcinoma</atitle><jtitle>Journal of stroke and cerebrovascular diseases</jtitle><addtitle>J Stroke Cerebrovasc Dis</addtitle><date>2018-05</date><risdate>2018</risdate><volume>27</volume><issue>5</issue><spage>e75</spage><epage>e77</epage><pages>e75-e77</pages><issn>1052-3057</issn><eissn>1532-8511</eissn><abstract>A 65-year-old woman presented to our emergency room because of sudden onset of right hemiparesis with severe fatigue. Neurological examination revealed right hemiparesis with right facial numbness and an extensor planter response on the right side.Magnetic resonance imaging with diffusion-weighted imaging revealed multiple highintensity areas in both cerebral hemispheres and the right cerebellum. A diagnosis of acute stage of multiple brain infarctions caused by emboli was made. An abdominal computed tomography showed a pancreatic tumor with multiple liver metastases. High D-dimer and serum carbohydrate antigen 19-9 concentration strongly suggested Trousseau syndrome associated with pancreatic cancer. The patient had another large embolic stroke and died on day 47. Autopsy was performed. There were large thrombi in the left ventricular apex and in the left atrial appendage There was also a papillary-shaped vegetation on the aortic valve that consisted mainly of fibrin without any inflammatory cells or destruction of the valve, these findings being characteristic of NBTE. This case is remarkable in that the patient had 3 different types of cardiac thrombi in her heart associated with Trousseau syndrome.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29503168</pmid><doi>10.1016/j.jstrokecerebrovasdis.2017.12.005</doi><orcidid>https://orcid.org/0000-0002-5093-3402</orcidid></addata></record> |
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| ispartof | Journal of stroke and cerebrovascular diseases, 2018-05, Vol.27 (5), p.e75-e77 |
| issn | 1052-3057 1532-8511 |
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| subjects | Aged Autopsy Blood Coagulation Brain Infarction - diagnostic imaging Brain Infarction - etiology CA-19-9 Antigen - blood Carcinoma - blood Carcinoma - complications Carcinoma - diagnostic imaging Carcinoma - secondary cerebral infarction Diffusion Magnetic Resonance Imaging Endocarditis, Non-Infective - blood Endocarditis, Non-Infective - diagnostic imaging Endocarditis, Non-Infective - etiology Fatal Outcome Female Fibrin Fibrinogen Degradation Products - analysis Heart Diseases - blood Heart Diseases - diagnostic imaging Heart Diseases - etiology Humans Intracranial Embolism - diagnostic imaging Intracranial Embolism - etiology Liver Neoplasms - secondary Nonbacterial thrombotic endocarditis pancreatic cancer Pancreatic Neoplasms - blood Pancreatic Neoplasms - complications Pancreatic Neoplasms - diagnostic imaging Pancreatic Neoplasms - pathology Syndrome Thrombophilia - blood Thrombophilia - complications Thrombophilia - diagnosis Thrombosis - blood Thrombosis - diagnostic imaging Thrombosis - etiology Tomography, X-Ray Computed Trousseau syndrome |
| title | Multiple Thrombi in the Heart in Trousseau Syndrome Caused by Pancreatic Carcinoma |
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