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Hiperhomosisteinemi ve Düşük Kobalamin Düzeyi Olan Metilentetrahidrofolat Redüktaz C677T Heterozigot Mutasyonlu bir Hastada Renal Arter Tromboembolisi

Renal Artery Thromboembolism in a Patient with Hyperhomocysteinemia, Low Cobalamin Level, and a Methylenetetrahydrofolate Reductase C677T Heterozygous Mutation

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Abstract (2. Language): 
We present the case of a 56-year-old man with a renal artery thrombosis. The patient’s medical history was significant for a myocardial infarction 1 year earlier. There was no history of trauma, smoking, hypertension, or diabetes mellitus. In addition to the unilateral renal arterial thrombosis, our patient had hyperhomocysteinemia, a low cobalamin level, and a heterozygous C677T mutation of the methylene tetrahydrofolate reductase (MTHFR) gene. The homocysteine level decreased with cobalamin treatment. Other causes of thrombophilia were ruled out. In the current patient, we suggest that the cause of the previous myocardial infarction and recent renal artery thromboembolism might have been associated with the effects of hyperhomocysteinemia, a low cobalamin level, and presence of a heterozygous C677T mutation of the MTHFR gene.
Abstract (Original Language): 
Bu yazıda 56 yaşındaki bir erkek hastada gelişen renal arter tromboembolisi vakasını sunduk. Hastanın özgeçmişinde bir yıl önce geçirilmiş miyokard enfarktüsü öyküsü vardı. Hastada sigara, hipertansiyon, diabetes mellitus ve travma öyküsü olmamasına rağmen tek taraflı renal arter tromboembolisi gelişmişti. Embolinin yanısıra hastada hiperhomosisteinemi, düşük kobalamin düzeyi ve metilentetrahidrofolat redüktaz C677T heterozigot mutasyonu (MTHFR) saptandı. Kobalamin tedavisini takiben homosistein düzeyleri düştü. Diğer trombofili sebepleri ise ekarte edildi. Bu hastada önceki miyokard enfarktüsünün ve yeni renal arter tromboembolisinin hiperhomosisteinemi, düşük kobalamin düzeyi ve MTHFR mutasyonu ile ilişkili olabileceği düşündük.
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