Paget-Schroetter disease 2991562 221301194 2008-06-23T22:44:08Z DOI bot 6652755 Citation maintenance. Initiated by [[User:Fconaway|Fconaway]]. You can [[WP:DOI|use this bot]] yourself! Please [[User:DOI_bot/bugs|report any bugs]]. {{Infobox_Disease | Name = Paget-Schroetter disease | Image = Gray576.png | Caption = Anterior view of right upper limb and thorax | DiseasesDB = 34349 | ICD10 = {{ICD10|I|82|8|i|80}} | ICD9 = {{ICD9|453.8}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 2772 | MeshID = | }} '''Paget-Schroetter disease''' ('''Paget-von Schrötter disease''') refers to [[deep vein thrombosis]] of an upper extremity vein, including the [[axillary vein]] or [[subclavian vein]]. ==Presentation== The syndrome is also known as “effort-induced thrombosis” as it has been reported to occur after vigorous activity, though it can also occur spontaneously. It usually presents in young and otherwise healthy patients, males more often than females. Symptoms include sudden onset of pain, warmth, redness, and swelling in the arm. These DVT's should be treated as an emergency, but rarely cause fatal pulmonary emboli. ==Treatment== The traditional treatment for thrombosis is the same as for a lower extremity deep vein thrombosis, and involves [[anticoagulation]] with [[heparin]] (generally [[low molecular weight heparin]]) with a transition to [[warfarin]]. However, J. Ernesto Molina, MD, a vascular surgeon at the University of Minnesota, has expressed the following opinion:<ref>{{cite web |url=http://www.circ.ahajournals.org/cgi/content/full/111/9/e118#R2-160023 |title=Letter Regarding Article by Martinelli et al, "Risk Factors and Recurrence Rate of Primary Deep Vein Thrombosis of the Upper Extremities" * Response -- Molina et al. 111 (9): e118 -- Circulation |accessdate=2007-07-02 |format= |work=}}</ref> "The current acceptable treatment for that condition is lytic therapy followed by surgery. The patients were followed up to investigate the rate of recurrence. However, if surgery is not done, the problem will invariably recur.2–4 If patients are treated with only anticoagulants and even thrombolytics but no surgery, I expect the recurrence rate to be high." Because "most of the patients who suffer this condition do not have any abnormality in their coagulation mechanism" and in fact suffer from "a direct injury to the endothelium," the "treatment for Paget-Schroetter syndrome ... entails the use of thrombolytics ''followed by surgery'' to decompress the thoracic inlet and widening of the vein, usually with a vein patch." ==Eponym== It is named for James Paget<ref>{{WhoNamedIt|synd|1924}}</ref><ref>J. Paget. On gouty and some other forms of phlebitis. St. Bartholomew’s Hospital Reports, London, 1866, 2: 82-92.</ref> and Leopold von Schrötter.<ref>L. von Schrötter. Erkrankungen der Gefässe. Nothnagel’s Handbuch der speciellen Pathologie und Therapie, 1901. Volume XV, II. Theil, II. Hälfte: Erkrankungen der Venen. Wien, Hölder, 1899: 533–535.</ref> ==See also== * [[Thoracic outlet syndrome]], a possible cause of blot clots in arms == Trivia == The father of a patient used [[Google]] to diagnose his son's Paget-Von Schrötter syndrome by querying on the symptoms, and it resulted in one of the first descriptions of "googling for diagnosis".<ref>{{Cite journal | author = Hangwi Tang & Jennifer Hwee Kwoon Ng | title = Googling for a diagnosis—use of Google as a diagnostic aid: internet based study | journal = [[BMJ]] | volume = 333 | pages = 1143–1145 | month = December | year = 2006 | doi = 10.1136/bmj.39003.640567.AE | pmid = 17098763 }}</ref> ==References== {{reflist}} ==External links== * [http://rad.usuhs.mil/medpix/medpix.html?mode=single&comebackto=mode%3Dcat_browse&recnum=4200 Overview] at [[Uniformed Services University of the Health Sciences]] {{Vascular diseases}} [[Category:Hematology]] [[Category:Angiology]]