Psorijaza kao faktor rizika od plućne embolije
Sažetak
Apstrakt
Uvod. Duboka venska tromboza i plućna embolija, poznate kao venski tromboembolizam (VTE), predstavljaju veliko globalno operećenje. Oba entiteta dele iste faktore rizika. Psorijaza je česta hronična bolest kože. Takođe, predstavlja multisistemsko inflamatorno oboljenje, dominantno zahvatajući kožu i zglobove koje je povezano sa značajnim kardiovaskularnim, metaboličkim stanjima i komorbiditetima, tzv. “psorijatični marš”. Prikaz bolesnika. U radu prikazujemo 78-godišnju bolesnicu sa psorijazom udruženom sa plućnim embolizmom koji je slučajno otkriven. Nije utvrđen drugi predisponirajući faktor (primarna ili sekundarna trombofilija), izuzev hiperhomocisteinemije. Bolesnica je lečena niskomolekulskim heparinom (enoksafarin) i oralnim antagonistom vitamina K (varfarin natrijum), u dozama određenim prema telesnoj težini. Dodatno smo preporučili kompleks vitamina B i folate. Pretpostavljena veza između hiperhomocisteinemije i psorijaze predstavlja snižen nivo folata u serumu, kao posledica njegove povećane potrošnje u koži, zbog povećane sinteze DNK. Zaključak. Prikazani slučaj ilustruje podatke iz literature da su bolesnici sa psorijazom u povišenom riziku od venskog i arterijskog tromboembolizma. Rizik je viši kod bolesnika sa teškim oblikom bolesti, što može biti posledica sistemske inflamacije i hiperhomocisteinemije.
Reference
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