Deep Vein Thrombosis in Patients with Severe Motor and Intellectual Disabilities

Hiromitsu Ohmori; Fumihiro Ochi; Naoyuki Tanuma; Eiichi Ohnuki; Masami Yamasaki; Hiroko Takesu; Miki Kan; Nobuo Matsumoto; Ryo Sumimoto; Akira Harada

doi:10.3400/avd.oa.13-00090

Selection from the Japanese Journal of Phlebology 2012

Deep Vein Thrombosis in Patients with Severe Motor and Intellectual Disabilities

Hiromitsu Ohmori, Fumihiro Ochi, Naoyuki Tanuma, Eiichi Ohnuki, Masami Yamasaki, Hiroko Takesu, Miki Kan, Nobuo Matsumoto, Ryo Sumimoto, Akira Harada

Author information

Hiromitsu Ohmori
Department of Pediatrics, National Hospital Organization Yanai Medical Center, Yamaguchi, Japan
Fumihiro Ochi
Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
Naoyuki Tanuma
Department of Pediatrics, Tokyo Metropolitan Fuchu Center for the Disabled, Tokyo, Japan
Eiichi Ohnuki
Department of Neurology, National Hospital Organization Yanai Medical Center, Yamaguchi, Japan
Masami Yamasaki
Department of Neurology, National Hospital Organization Yanai Medical Center, Yamaguchi, Japan
Hiroko Takesu
Department of Laboratory, National Hospital Organization Yanai Medical Center, Yamaguchi, Japan
Miki Kan
Department of Medical Laboratory, Ehime Prefectural Central Hospital, Ehime, Japan
Nobuo Matsumoto
Department of Internal Medicine, National Hospital Organization Yanai Medical Center, Yamaguchi, Japan
Ryo Sumimoto
Department of Surgery, National Hospital Organization Yanai Medical Center, Yamaguchi, Japan
Akira Harada
Department of Neurology, National Hospital Organization Yanai Medical Center, Yamaguchi, Japan

Keywords: severe motor and intellectual disabilities (SMID), deep vein thrombosis (DVT), pulmonary thromboembolism, ultrasonography

JOURNAL FREE ACCESS

2013 Volume 6 Issue 4 Pages 694-701

DOI https://doi.org/10.3400/avd.oa.13-00090

Browse “Advance online publication” version

Details

Abstract

Most patients with severe motor and intellectual disabilities (SMID) have restricted mobility capability and have been bedridden for long periods because of paralysis of the extremities caused by abnormal muscular tonicity due to cerebral palsy and developmental disabilities, and such patients are associated with a high risk for the complications of deep vein thrombosis (DVT). Here, we report 8 patients (34.8%) with DVT among 23 patients with SMID during prolonged bed rest. However, we did not detect thrombosis in the soleal veins, finding it mostly in the superficial femoral and common femoral veins. Regarding laboratory data for the coagulation system, there were no cases with D-dimer above 5 µg/ml. Concerning sudden death in patients with SMID, we have to be very careful of the possibility of pulmonary thromboembolism due to DVT. Therefore, we should consider the particularities of an underdeveloped vascular system from underlying diseases for the evaluation of DVT in patients with SMID. A detailed study of DVT as a vascular complication is very important for smooth medical care of SMID and compression Doppler ultrasonography of the lower extremities, as noninvasive examination, is very helpful. (*English translation of Jpn J Phlebol 2012; 23: 17-24)

Corresponding author

Register with J-STAGE for free!