Abstract
Pulmonary vein thrombosis (PVT) is a challenging diagnosis and has been described in association with or as a complication of pulmonary tumors, lung surgeries, atrial myxoma, and after radiofrequency catheter ablation for atrial fibrillation. There are not many reported cases of PVT associated with medication use. We present a case of a 53-year-old male with a history of severe persistent asthma on omalizumab, who presented with shortness of breath and was found to have PVT on computed tomography scan of the chest. The hypercoagulable workup was normal, and the patient did not have a history of malignancy or pulmonary surgeries. Currently, available data suggest an association between omalizumab use and increased risk of arterial thrombotic events. However, on a literature search, we could not find any reported cases of PVT with omalizumab treatment.
Highlights
Pulmonary vein thrombosis (PVT) is a rare entity, which has been a reported complication of pulmonary malignancy, lung transplantation, pulmonary lobectomy, and radiofrequency ablation for atrial fibrillation.[1,2] The diagnosis is challenging secondary to nonspecific clinical presentations with dyspnea, cough, pleuritic chest pain, and hemoptysis
We present a case of PVT in a patient on treatment with omalizumab for severe persistent asthma
The usual presenting symptoms are cough, dyspnea, pleuritic chest pain, and hemoptysis, which are nonspecific. It might present after pulmonary lobectomy, lung transplantation, lung tumors, radiofrequency ablation for atrial fibrillation, and sclerosing mediastinitis.[1,2]
Summary
Pulmonary vein thrombosis (PVT) is a rare entity, which has been a reported complication of pulmonary malignancy, lung transplantation, pulmonary lobectomy, and radiofrequency ablation for atrial fibrillation.[1,2] The diagnosis is challenging secondary to nonspecific clinical presentations with dyspnea, cough, pleuritic chest pain, and hemoptysis. We present a case of PVT in a patient on treatment with omalizumab for severe persistent asthma. A 53-year-old Caucasian male presented to the emergency department with complaints of shortness of breath, wheezing, and cough He had past medical history significant for multiple sclerosis, severe persistent asthma, and allergies. The patient was being treated with omalizumab for 2 years for underlying allergic asthma He had no recent surgical interventions on the lungs, no family history of hereditary thrombophilia, and no history of atrial fibrillation. A chest computed tomography (CT) with pulmonary embolism protocol revealed thrombosis of the right inferior pulmonary vein and thrombosis extending to but not into the left atrium (as shown in Figures 1 and 2) This was a new finding compared to a chest CT obtained 3 years ago.
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