|
|
Blood, 15 September 2007, Vol. 110, No. 6, pp. 1723-1729.
Prepublished online as a Blood First Edition Paper on May 11, 2007; DOI 10.1182/blood-2006-10-053736.
 Previous Article | Next Article 
Submitted October 24, 2006
Accepted May 8, 2007
Trousseau's Syndrome: multiple definitions and multiple mechanisms
Ajit Varki*
Department of Medicine, University of California, San Diego, La Jolla, CA, United States
* Corresponding author; email: a1varki{at}ucsd.edu.
In 1865 Armand Trousseau noted that unexpected and/or migratory thrombophlebitis could be a forewarning of an occult visceral malignancy. An analysis by Sack and colleagues in 1977 extended the term "Trousseau's Syndrome" to include chronic disseminated intravascular coagulopathy associated with microangiopathy, verrucous endocarditis and arterial emboli in patients with cancer, often occurring with mucin-positive carcinomas. In recent times the term has been ascribed to clinical situations ranging all the way from these classic descriptions, to any kind of coagulopathy occurring in the setting of any kind of malignancy. These multiple definitions of "Trousseau's Syndrome" are partly the consequence of multiple pathophysiological mechanisms that apparently contribute to the hypercoagulability associated with cancer. Even the classic syndrome appears likely to represent a spectrum of disorders, ranging from exaggerated fluid-phased thrombosis dependent on prothrombotic agents such as tissue factor to a platelet- and endothelium-based selectin-dependent microangiopathy associated with mucin-producing carcinomas, along with thrombin and fibrin production. Also considered here are recent hypotheses concerning genetic pathways within tumor cells that might trigger these thrombotic phenomena, and the reasons why therapy with heparins of various kinds remain the preferred treatment - likely because of their salutary actions on several of the proposed pathological mechanisms.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
J. I. Zwicker, H. A. Liebman, D. Neuberg, R. Lacroix, K. A. Bauer, B. C. Furie, and B. Furie
Tumor-Derived Tissue Factor-Bearing Microparticles Are Associated With Venous Thromboembolic Events in Malignancy
Clin. Cancer Res.,
November 15, 2009;
15(22):
6830 - 6840.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Khorana and G. C. Connolly
Assessing Risk of Venous Thromboembolism in the Patient With Cancer
J. Clin. Oncol.,
October 10, 2009;
27(29):
4839 - 4847.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. P. Shivakumar, D. R. Anderson, and S. Couban
Catheter-Associated Thrombosis in Patients With Malignancy
J. Clin. Oncol.,
October 10, 2009;
27(29):
4858 - 4864.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Boccaccio and P. M. Comoglio
Genetic Link Between Cancer and Thrombosis
J. Clin. Oncol.,
October 10, 2009;
27(29):
4827 - 4833.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. H. Lyman and A. A. Khorana
Cancer, Clots and Consensus: New Understanding of an Old Problem
J. Clin. Oncol.,
October 10, 2009;
27(29):
4821 - 4826.
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Starling, S. Rao, D. Cunningham, T. Iveson, M. Nicolson, F. Coxon, G. Middleton, F. Daniel, J. Oates, and A. R. Norman
Thromboembolism in Patients With Advanced Gastroesophageal Cancer Treated With Anthracycline, Platinum, and Fluoropyrimidine Combination Chemotherapy: A Report From the UK National Cancer Research Institute Upper Gastrointestinal Clinical Studies Group
J. Clin. Oncol.,
August 10, 2009;
27(23):
3786 - 3793.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Provencal, D. Labbe, R. Veitch, D. Boivin, G.-E. Rivard, H. Sartelet, Y. Robitaille, D. Gingras, and R. Beliveau
c-Met activation in medulloblastoma induces tissue factor expression and activity: effects on cell migration
Carcinogenesis,
July 1, 2009;
30(7):
1089 - 1096.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. H. Thiers, R. E. Sahn, and J. P. Callen
Cutaneous Manifestations of Internal Malignancy
CA Cancer J Clin,
March 3, 2009;
(2009)
caac.20005v1.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
D. MICKELSON, E. N. MADY, and K. TENG
A 43-year-old woman with chest pressure
Cleveland Clinic Journal of Medicine,
March 1, 2009;
76(3):
191 - 198.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Sousou and A. A. Khorana
New Insights Into Cancer-Associated Thrombosis
Arterioscler Thromb Vasc Biol,
March 1, 2009;
29(3):
316 - 320.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. L. Ornstein
A Nickel's Worth of Cancer
Ann Intern Med,
September 2, 2008;
149(5):
350 - 352.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Furie and B. C. Furie
Mechanisms of Thrombus Formation
N. Engl. J. Med.,
August 28, 2008;
359(9):
938 - 949.
[Full Text]
[PDF]
|
|
|
|
|
