02036nas a2200241   4500000000100000008004100001260001200042653004200054653002700096653002700123653003800150653002300188100001600211700001200227700001100239700001600250700001200266245008100278856010300359300000800462520131000470022001401780       2023                            d  bMedknow10aSafety, Risk, Reliability and Quality10aBorderline lepromatous10aBorderline tuberculoid10a external jugular vein thrombosis10aHansen’s disease1 aChaudhuri D1 aSwain P1 aNair V1 aVasudevan B1 aYadav Y00aExternal jugular veinous thrombosis: A rare presentation of Hansen's disease  uhttps://journals.lww.com/ijvs/Abstract/9000/External_Jugular_Veinous_Thrombosis__A_Rare.99988.aspx  a1-33 a<p>Veinous thrombosis is a rare manifestation of leprosy (Hansen’s disease). In this case report, we bring to notice this extremely rare presentation and challenges faced during management. A 26-year-old young healthy individual presented with painless cord-like swellings on both sides of the neck for 1 month. This was evaluated to be external jugular vein (EJV) thrombosis on ultrasonography Doppler. Trying to evaluate the cause of the thrombosis, there was no specific etiology found. On further detailed evaluation, it was found that he had hypopigmented skin patches. This led to the diagnosis of&nbsp;borderline tuberculoid&nbsp;leprosy downgrading to&nbsp;borderline lepromatous&nbsp;in type 1 lepra reaction. He responded to rifampicin, clofazimine, and dapsone with progressive resolution of skin lesions. Simultaneous treatment with apixaban caused complete resolution of EJV thrombosis. Further evaluation revealed heterozygous methylenetetrahydrofolate reductase mutation and beta-2-glycoprotein immunoglobulin M positivity. An extensive literature review suggested that intimal damage caused by lepra bacilli can lead to veinous thrombosis in&nbsp;Hansen’s disease. However, the interplay of genetic procoagulant predispositions in phenotypic presentation is yet to be determined.</p>
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