Bilateral lower limbs DVT in a young female

This is a case scenario of a young female patient with bilateral lower limbs DVT (deep vein thrombosis). She was diagnosed with a rare disease. please write your answers in the comment box below.

Answers is displayed at the end of the article

Case Presentation of the patient with bilateral lower limbs DVT

A 20 years old female presented in the medical OPD with bilateral lower limbs DVT (deep vein thrombosis). There is no history of prolonged bed rest, surgery, previous DVTs or oral contraceptive use. There is no history of arthritis but she has a history of episodic red eyes and painful oral ulcer for the last one year.

bilateral lower limbs dvt
deep vein thrombosis of the lower limbs

Her investigations for the cause of DVT were carried out. Autoimmune profile including ANA (antinuclear antibody tests), antiphospholipid antibodies, Protein C levels, protein S levels, and homocysteine levels were unremarkable. Her ESR was 80 mm in the first hour. During admission in the hospital, she developed a papulopustular eruption at the site of intravenous cannulation and subcutaneous injection sites.

What bedside test would help us to diagnose this patient?

What is the possible diagnosis?

bilateral lower limbs dvt

What bedside test would help us to diagnose this patient?

Pathergy test.

How to perform the pathergy test?

  • A sterile sharp needle (20 G) is inserted into the skin of the forearm. The development of an inflammatory papule or a pustule within 24-48 hours constitutes a positive result. This finding reflects an overactive immune response to minor injuries. Histologic studies of these lesions reveal mononuclear cell infiltrates and keratinocytes.
  • The pathergy test is helpful but is not sensitive or specific for the diagnosis of Behcet disease.

What is the possible diagnosis?

Behcets disease.

Why the picture below has been used as the featured image in the article?

bilateral lower limbs dvt
silk route

This is the ancient silk route. Behcet’s disease also called the ancient silk route disease is more prevalent in areas surrounding the ancient silk route.

A review of Behcet’s disease has been posted in the next article.

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