Vascular Manifestations of Hyperhomocysteinemia

Introduction Hyperhomocysteinemia (HHC ) is a growing risk factor for thromboembolic disease. Involved initially in the pathogenesis of atherosclerosis and arterial thrombosis, was subsequently recognized as a risk factor for venous thromboembolic events. The aim of our work is to describe the characteristics of the vascular manifestations of the Hyperhomocysteinemia. Patients and methods This is a retrospective study of all cases ofHHC with vascular stroke in a Department of Internal Medicine over a 17-year period from January 2000 to January 2017 and presenting with vascular manifestations of hyperhomocysteinemia Results There were 18 patients, including 15 men and 3 women, with an average age of 58.4 years (range 19 to 77 years). Thrombo-embolic manifestations were venous thrombosis in 11 cases. It was deepthrombosis in 9 cases and superficial one in two cases. Venous thrombosis was localized at the lower limb in all cases. It was recurrent in 4 cases and was complicated with pulmonary embolism in 2 cases. HHC was associated with an anti-phospholipid antibody syndrome in 1 case. In other cases, no constitutional venous thromboembolic risk factor. Arterial thromboses were noted in 7 patients. It was an ischemic stroke in 5 cases and a coronary syndrome in 2 cases. HHC was noted in 4 patients without other cardiovascular risk factors. A Biermer disease was associated in 3 cases. These patients received a substitutive treatment in addition to anticoagulation. Conclusion Accountability of hyperhomocysteinemia in the pathogenesis of thromboembolism is currently subject to a controversial subject. In a context of hyperhomocysteinemia we have to search othersconstutional or acquired thrombophilic factors such as biermer disease .