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Presumed paradoxical embolus in a patient with diabetic ketoacidosis

Authors Langevin C, Lamarche C, Bell R, Vallée M

Received 28 April 2015

Accepted for publication 9 July 2015

Published 18 September 2015 Volume 2015:8 Pages 297—301


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Catherine Langevin, Caroline Lamarche, Robert Z Bell, Michel Vallée

Department of Nephrology, Maisonneuve-Rosement Hospital, Montreal, QC, Canada

Abstract: Thrombotic complications figure among the most frequent causes of mortality in diabetic ketoacidosis (DKA) and hyperosmolar state. We report the case of a 55-year-old woman presenting with DKA whereby a newly discovered patent foramen ovale was found due in part to the observation of bilateral deep vein thrombosis in legs, bilateral multiple pulmonary embolisms, and left subclavian acute artery thrombosis. Diabetes is known as a hypercoagulability state, and DKA is rising as a risk factor for vascular events. The importance of prophylactic anticoagulation should be emphasized in this setting.

Keywords: thrombosis, hypercoagulability, prophylactic anticoagulation, pulmonary embolism

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