PROGNOSIS IN IDIOPATHIC THOMBOPHLEBITIS

Abstract

By means of a review of case records and follow-up letters, 88 cases of idiopathic thrombophlebitis have been studied for a period of 5 or more yrs. from the time of initial examination and diagnosis. 29 patients (33%) had had only a single episode of thrombophlebitis prior to the time of initial diagnosis of idiopathic thrombophlebitis. 59 patients (67%) had had multiple episodes prior to the time of the initial diagnosis. The complications, chronic venous insufficiency and pulmonary embolism, occurred in a relatively large number of patients. A greater incidence of the former occurred in those patients with multiple episodes of thrombophlebitis. Death from a thrombo-embolic episode occurred in 1 case (mesenteric thrombosis). In 7 other cases there exists the possibility that a fatal thrombo-embolic episode may have occurred. Sufficient information was lacking to make certain of the diagnosis in these cases. 9 patients (10%) subsequently had clinical evidence of a systemic disease, which may have been an etiologic factor in the development of the thrombophlebitis. Malignant tumors developed in 5 patients. Hodgkin''s disease developed in 1 patient, polycythemia vera in 1, and thromboangiitis obliterans in 2. Idiopathic thrombophlebitis occurs predominantly in the male. There were only 9 females (10%) in the entire group of 88 cases. Only 1 female patient (1%) had recurrent thrombophlebitis. 11 (38%) of the 29 patients with a single episode of thrombophlebitis is were asymptomatic in the ensuing 5 yrs. 6 (10%) of the 59 patients with multiple episodes of thrombophlebitis likewise had no further trouble. Discontinuance of the use of tobacco seemed to have little effect in preventing recurrences of thrombophlebitis.