Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.005417
Jornal Vascular Brasileiro
Case Report

Klippel-Trenaunay and Parkes-Weber syndromes: two case reports

Síndromes de Klippel-Trenaunay e Parkes-Weber: dois relatos de caso

Carlos Alberto Araujo Chagas, Lucas Alves Sarmento Pires, Marcio Antonio Babinski, Tulio Fabiano de Oliveira Leite

Downloads: 4
Views: 1832

Abstract

Parkes-Weber syndrome is a congenital vascular disease that comprises capillary, venous, lymphatic, and arteriovenous malformations. Although Parkes-Weber syndrome is a clinically distinct entity with serious complications, it is still frequently misdiagnosed as Klippel-Trenaunay syndrome, which consists of a triad of malformations involving the capillary, venous, and lymphatic vessels, without arteriovenous fistulas. Both syndromes are generally diagnosed with Doppler ultrasound and confirmed by magnetic resonance angiography. The aim of this study is to describe one case of Klippel-Trenaunay syndrome, in a 36-year-old patient, and one case of Parkes-Weber syndrome, in a 21-year-old patient. We review the literature in order to discuss the possible causes and consequences of these diseases related to venous hypertension and angiodysplasia, taking a clearer approach to their differences, and discussing their treatment.

Keywords

Klippel-Trenaunay syndrome; Parkes-Weber syndrome; angiodysplasia; nevus; arteriovenous malformations

Resumo

A síndrome de Parkes-Weber é uma doença vascular congênita que consiste em malformações capilares, venosas, linfáticas e arteriovenosas. Embora seja uma entidade clinicamente distinta com complicações graves, essa síndrome ainda é frequentemente diagnosticada erroneamente como síndrome de Klippel-Trenaunay, que consiste em uma tríade de má formação nos vasos capilares, venosos e linfáticos, sem fístula arteriovenosa. Ambas as síndromes são geralmente diagnosticadas através de ultrassom Doppler e confirmadas pela angiografia por ressonância magnética. O objetivo deste estudo é descrever um caso de síndrome de Klippel-Trenaunay em um paciente de 36 anos de idade e um caso de síndrome de Parkes-Weber em uma paciente de 21 anos. A literatura foi revisada com o objetivo de discutir as possíveis causas e consequências dessa doença e sua associação à hipertensão venosa e angiodisplasia. O presente trabalho também levanta discussão a respeito das diferenças sintomatológicas de ambas as síndromes e seus respectivos tratamentos.

Palavras-chave

síndrome de Klippel-Trenaunay; síndrome de Parkes-Weber; angiodisplasias; nevus; malformações arteriovenosas.

References

1. International Society for the Study of Vascular Anomalies©. Classification of vascular anomalies. Milwaukee, WI, US: ISSVA; 2014 [cited 2017 abr 18]. http://www.issva.org/classification.

2. Agrawal N, Vasavada A. Rare Association of Klippel-Trenaunay Syndrome with Large Pulmonary Embolism and Asymmetrical Emphysematous Bullae. J Coll Physicians Surg Pak. 2016;26(5):432-4. PMid:27225153.

3. Mneimneh S, Tabaja A, Rajab M. Klippel-Trenaunay Syndrome with Extensive Lymphangiomas. Case Rep Pediatr. 2015;2015(2015):581394. PMid:26587303. http://dx.doi.org/10.1155/2015/581394.

4. Vahidnezhad H, Youssefian L, Uitto J. Klippel–Trenaunay syndrome belongs to the PIK3CA-related overgrowth spectrum (PROS). Exp Dermatol. 2016;25(1):17-9. PMid:26268729. http://dx.doi.org/10.1111/exd.12826.

5. Hu Y, Li L, Seidelmann SB, et al. Identification of association of common AGGF1 variants with susceptibility for KlippelTrenaunay syndrome using the structure association program. Ann Hum Genet. 2008;72(5):636-43. PMid:18564129. http://dx.doi.org/10.1111/j.1469-1809.2008.00458.x.

6. Husmann DA, Rathburn SR, Driscoll DJ. Klippel-Trenaunay syndrome: incidence and treatment of genitourinary sequelae. J Urol. 2007;177(4):1244-9. PMid:17382698. http://dx.doi.org/10.1016/j.juro.2006.11.099.

7. Banzic I, Brankovic M, Maksimović Ž, Davidović L, Marković M, Rančić Z. Parkes Weber syndrome – diagnostic and management paradigms: a systematic review. Phlebology. 2017;32(6):371-83. PMid:27511883. http://dx.doi.org/10.1177/0268355516664212.

8. Bhat L, Bisht S, Khanijo K. Klippel-Trenaunay-Weber Syndrome with Kasabach-Merritt Coagulopathy and Hydronephrosis. Indian Pediatr. 2015;52(11):987-8. PMid:26615353. http://dx.doi.org/10.1007/s13312-015-0760-5.

9. Sung HM, Chung HY, Lee SJ, et al. Clinical Experience of the Klippel–Trenaunay Syndrome. Arch Plast Surg. 2015;42(5):552-8. PMid:26430625. http://dx.doi.org/10.5999/aps.2015.42.5.552.

10. Abdolrahimzadeh S, Scavella V, Felli L, Cruciani F, Contestabile MT, Recupero SM. Ophthalmic alterations in the Sturge-Weber Syndrome, Klippel-Trenaunay Syndrome, and the Phakomatosis Pigmentovascularis: an independent group of conditions? BioMed Res Int. 2015;2015: 786519. PMid:26451379. http://dx.doi.org/10.1155/2015/786519.

11. Eerola I, Boon LM, Mulliken JB, et al. Capillary Malformation– Arteriovenous Malformation, a new clinical and genetic disorder caused by RASA1 mutations. Am J Hum Genet. 2003;73(6):1240-9. PMid:14639529. http://dx.doi.org/10.1086/379793.

12. Ilhanli I, Keskin O, Arslan E, Ekiz M. Sciatic nerve hypertrophy with Klippel-Trenaunay Syndrome: a case report. Turk Neurosurg. 2015;25(3):500-2. PMid:26037196.

13. Sahin ON, Atik T, Coğulu O, Ozkinay E. The spectrum of clinical features associated with Klippel-Trenaunay-Weber syndrome. Genet Couns. 2015;26(2):249-51. PMid:26349197.

14. Jacob AG, Driscoll DJ, Shaughnessy WJ, Stanson AW, Clay RP, Gloviczki P. Klippel-Trénaunay Syndrome: spectrum and management. Mayo Clin Proc. 1998;73(1):28-36. PMid:9443675. http://dx.doi.org/10.1016/S0025-6196(11)63615-X.

15. Baskerville PA, Ackroyd JS, Browse NL. The etiology of the KlippelTrenaunay Syndrome. Ann Surg. 1985;202(5):624-7. PMid:2996451. http://dx.doi.org/10.1097/00000658-198511000-00015.

16. Lorimier AA. Sclerotherapy for venous malformations. J Pediatr Surg. 1995;30(2):188-94. PMid:7738736. http://dx.doi.org/10.1016/0022-3468(95)90558-8.

17. Yamaki T, Nozaki M, Sakurai H, Takeuchi M, Soejima K, Kono T. Prospective randomized efficacy of ultrasound-guided foam sclerotherapy compared with ultrasound-guided liquid sclerotherapy in the treatment of symptomatic venous malformations. J Vasc Surg. 2008;47(3):578-84. PMid:18295109. http://dx.doi.org/10.1016/j.jvs.2007.11.026.

18. Tessari L. Nouvelle technique d’obtension de la sclero-mousse. Phlebologie. 2000;53:129.

19. Cabrera J, Cabrera J Jr, García-Olmedo MA. Elargissement des limites de la sclerotherapie: nouveaux produits sclerosants. Phlebologie. 1997;2(4):181-8.

20. Chagas C, Duque F, Mello N, Barros S, Silva J. Klippel Trenaunay Parkes Weber syndrome: case report in Santa Casa da Misericordia do Rio de Janeiro General Hospital, Rio de Janeiro, Brazil – literature review. Minerva Med. 2007;26(1 Suppl):103-103.

21. Upadhyay H, Sherani K, Vakil A, Babury M. A case of recurrent massive pulmonary embolism in Klippel-Trenaunay-Weber syndrome treated with thrombolytics. Respir Med Case Rep. 2016;17:68-70. PMid:27141435.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5cd2e9060e88251512632f8f jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections