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Rare disease
Case report
Fibromuscular dysplasia presenting with a deep vein thrombosis
  1. Danielle Lam1,
  2. Shirley Jansen2,3,
  3. Jonathan Tibballs4 and
  4. Andrew McLean-Tooke1,5
  1. 1Department of Clinical Immunology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  2. 2Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  3. 3Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  4. 4Department of Interventional Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  5. 5Department of Immunology, PathWest Laboratory Medicine Western Australia, Perth, Western Australia, Australia
  1. Correspondence to Dr Andrew McLean-Tooke; andymctooke{at}yahoo.co.uk

Abstract

A 41-year-old male patient presented with isolated right lower limb swelling. An ultrasound scan showed right external iliac and femoral vein deep vein thrombosis due to extrinsic compression by an aneurysm of the right common iliac artery. Investigations including imaging and a tissue biopsy of right and left femoral arteries confirmed a rare clinical presentation of fibromuscular dysplasia involving iliac, coeliac, renal and pulmonary vessels. The common iliac artery aneurysm was successfully treated with endovascular repair. Six months later, he developed coronary artery involvement with spontaneous dissection of left anterior descending artery diagnosed on coronary angiogram which was managed conservatively. At 6-year follow-up, he remains clinically asymptomatic and continues with regular surveillance imaging. Iliac arterial fibromuscular dysplasia is uncommon and clinical presentation with a complication such as a deep vein thrombosis is atypical.

  • vascular surgery
  • connective tissue disease

https://doi.org/10.1136/bcr-2019-233315

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    Footnotes

    • Contributors DL wrote the manuscript. AM-T was involved in initial patient diagnosis and SJ performed the surgery. JT reviewed the radiology images. AM-T, JT and SJ reviewed and edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.