Vignale R, Allallón W

Language: Spanish
References: 22
Page: 42-44
PDF size: 108.43 Kb.

ABSTRACT

A 58 year-old woman treated at the Cardiologic Clinic due to multiples myocardial infarctions associated to arterial hypertension since 1992 is presented. In October 2000 she presented an aterosclerotic leg ulcer. The patient suffered a severe malnutrition, with personal history of alcoholism and smoker. Laboratory test showed a high level of plasma homocysteine with values ranging between 50 to 60 umnI/I (n.v: 5 –15 umoI/I). Coagulation test showed several abnormalities due to treatment with hypotensive and anticoagulant drugs (heparine, ticlopirine, dipiridamol). Treatment with Vitamin B1 (600 mg/d), B6 (600 mg/d), B12 (5000 mcg/d) and folic acid (49 mg/d) for several months showed an improvement on homocysteine levels (ranging from 20 to 25 umoI/I). Eleven months later a total healing of her leg ulcer was observed. It is probably that the main cause of the leg ulcer was the homocysteine metabolic disorder, damaging directly and by means several pathogenic mechanisms and the whole arterial wall, specially the endothelial cells. We suggest that arterial hypertension was not the main causative element since the leg ulcer appeared while the patient was taking for many years hypotensive and anticoagulant drugs. We conclude that the high level of homocysteine was secundary to metabolic alteratitions as the malnutrition.

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