How would you manage recurrent migratory lower extremity thrombophlebitis that occurs despite being on therapeutic apixaban?
No DVT. AC started due to extensive size of initial LLE SVT, with continued SVT of contralateral RLE despite therapeutic anticoagulation with apixaban. Prior work up for malignancy negative by imaging, and APLS negative for cardiolipin and beta 2 glycoprotein antibodies with no lupus anticoagulant due to continued anticoagulation.
Would a venogram to assess for anatomic anomalies of the proximal vessels be helpful? Would you consider expanded thrombophilia testing for protein C or S deficiency?
1 Answer
Mednet MemberInvited Expert
Pediatric Hematology/Oncology · St. Jude Children’s Research Hospital
Answered on
The differential diagnosis of Trousseau syndrome (migratory superficial thrombophlebitis) is relatively broad and includes both inflammatory states and undetected proximal DVTs. So I think the short answer about venogram is "maybe," based on how clear is the view by ultrasound. This isn't a typical ...
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