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Pulmonary Embolism in a Patient With Pernicious Anemia and Hyperhomocysteinemia*

Angel Caldera, MD; Jorge Mora, MD; Morris Kotler, MD; Glenn Eiger, MD
Author and Funding Information

*From the Department of Medicine (Drs. Caldera and Mora), and the Divisions of Cardiology (Dr. Kotler) and Pulmonary and Critical Care Medicine (Dr. Eiger), Albert Einstein Medical Center, Philadelphia, PA.

Correspondence to: Angel Caldera, MD, Department of Medicine, Albert Einstein Medical Center, 5401 Old York Rd, Philadelphia, PA 19141; e-mail: calderaa@einstein.edu



Chest. 2002;122(4):1487-1488. doi:10.1378/chest.122.4.1487
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We report the case of a 60-year-old woman with a history of ataxia who sought evaluation after a syncopal episode. A diagnostic workup revealed pulmonary emboli, pernicious anemia (PA), hyperhomocysteinemia, and a G20210A prothrombin gene mutation. She was successfully treated with homocysteine-lowering therapy, including high doses of oral cobalamin. She also received oral anticoagulation for 6 months. At 1 year of follow-up, no further thrombotic episodes had occurred. Our report highlights the thrombotic risk of hyperhomocysteinemia secondary to PA in a patient with the G20210A prothrombin gene mutation.

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