No abstract available.
Aged ; Anticoagulants/therapeutic use ; DNA Mutational Analysis ; Echocardiography ; Genetic Predisposition to Disease ; Homozygote ; Humans ; Hyperhomocysteinemia/blood/complications/diagnosis/drug therapy/*genetics ; Male ; Methylenetetrahydrofolate Reductase (NADPH2)/*genetics ; *Mutation ; Phenotype ; Pulmonary Embolism/blood/diagnosis/drug therapy/*etiology ; Severity of Illness Index ; Thrombolytic Therapy ; Tomography, X-Ray Computed ; Treatment Outcome ; Vitamins/therapeutic use

Thromboembolic events are reported to occur with a high frequency in the setting of malignancy. However, reports on an association between cholangiocarcinoma and pulmonary thromboembolism, thus far, are almost lacking. We present here an unusual case of a 56-yr-old patient presenting cholangiocarcinoma and unexplained pulmonary thromboembolism. The patient had been quite healthy before the diagnosis. Coagulation tests showed elevated levels of fibrinogen, fibrinogen degradation product (FDP), D-dimer, and IgM anticardiolipin antibody (aCL Ab). The thromboemboli were resolved 3 weeks after anticoagulant therapy using lowmolecular-weight-heparin. Then, follow-up coagulation tests showed a marked decrease to normal in aCL Ab titer as well as the normalization of FDP and D-dimer levels. In this case, we describe pulmonary thromboembolism caused by hypercoagulable state associated with cholangiocarcinoma and speculate that such a thrombotic phenomenon could be regressed by anticoagulant therapy.
Antibodies, Anticardiolipin/blood ; Anticoagulants/therapeutic use ; Bile Duct Neoplasms/*complications ; *Bile Ducts, Intrahepatic ; Blood Coagulation Factors/analysis ; Cholangiocarcinoma/*complications ; Fibrin Fibrinogen Degradation Products/analysis ; Fibrinogen/analysis ; Heparin, Low-Molecular-Weight/therapeutic use ; Humans ; Male ; Middle Aged ; Pulmonary Embolism/*blood/drug therapy/etiology ; Syndrome ; Treatment Outcome