Unexplained pulmonary embolism post SARS-CoV2 pneumonia in a patient with MYH9-related disease: a case report

Unexplained pulmonary embolism post SARS-CoV2 pneumonia in a patient with MYH9-related disease: a case report

Authors

  • Laura Tomaino a:1:{s:5:"en_US";s:82:"Emergency Medicine Residency Program, Marche Polytechnic University, Ancona, Italy";}
  • Vincenzo Giannicola Menditto Department of Internal and Emergency Medicine, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
  • Cinzia Nitti Department of Internal and Emergency Medicine, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
  • Gianluca Moroncini Clinica Medica, Azienda Ospedaliera Universitaria Ospedali Riuniti, Marche Polytechnic University, Ancona, Italy
  • Aldo Salvi Department of Internal and Emergency Medicine, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy

Keywords:

MYH9-related disease, macrothrombocytopenia, SARS-CoV-2 pneumonia, pulmonary embolism, ROTEM

Abstract

This report describes the case of a man affected by Myosin Heavy Chain 9 (MYH9)-related platelet disorder, with a recent history of SARS-CoV-2 pneumonia, who developed pulmonary embolism (PE). At the admittance the patient presented a marked thrombocytopenia. The rotational thromboelastometry (ROTEM) showed a reduction in maximum clot firmness. The CT scan showed a lobar PE while and no sign of superficial or deep venous thrombosis was found. Given the contraindication of anticoagulant therapy due to severe thrombocytopenia, after collegial evaluation of the case, an inferior vena cava filter was applied. The patient was discharged after 5 days of hospitalization, and fondaparinux 2.5 mg subcutaneously was prescribed for two months. Could MYH9 mutation contribute to thrombotic predisposition? Or rather the endothelial dysfunction induced by SARS-CoV-2 infection? The report presents a dissertation on the possible causes for the PE and describes the therapeutic strategy adopted.

References

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Published

26-11-2021

How to Cite

1.
Tomaino L, Menditto VG, Nitti C, Moroncini G, Salvi A. Unexplained pulmonary embolism post SARS-CoV2 pneumonia in a patient with MYH9-related disease: a case report. Acta Biomed [Internet]. 2021 Nov. 26 [cited 2024 Jul. 20];92(S1):e2021407. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/11968