Severe Acute Thromboinflammation: Case Report of Individualized Homeopathic Treatment
Thromboinflammation is a still not well-understood phenomenon, which has recently come to the foreground as a function of its relevance in the pathophysiology of coronavirus disease 2019 (COVID-19). The patient described in the present case report exhibited acute fever, giant urticaria, elevated acute phase reactants, and very high d-dimer levels, thus characterizing thromboinflammation. She was diagnosed as a COVID-19 suspect case, which was not confirmed; urticarial vasculitis was ruled out. Homeopathic treatment was started with the earliest clinical manifestations, resulting in rapid and drastic reduction of inflammation and hypercoagulability within the first 12 hours, and full recovery on 10-day follow-up assessment. This case demonstrates the effectiveness of homeopathy in a severe acute disorder, and points to the need to include laboratory testing in homeopathic clinical assessment to achieve an accurate picture of disease, and to avoid the risk of passing over life-threatening disorders.
• The present study is the report of a severe case of thromboinflammation.
• COVID-19 (coronavirus disease 2019) was the single diagnostic hypothesis, not confirmed.
• The patient was treated with an individualized single homeopathic medicine alone.
• Thromboinflammation parameters improved dramatically within the first 12 hours.
• Complete resolution was demonstrated after 10 days.
Received: 17 August 2020
Accepted: 01 September 2020
22 February 2021 (online)
© 2021. Faculty of Homeopathy. This article is published by Thieme.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Senst B, Tadi P, Goyal A. et al. Hypercoagulability. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2020. . Available at: https://www.ncbi.nlm.nih.gov/books/NBK538251/. Accessed June 1, 2020
- 2 Jackson SP, Darbousset R, Schoenwaelder SM. Thromboinflammation: challenges of therapeutically targeting coagulation and other host defense mechanisms. Blood 2019; 133: 906-918
- 3 Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood 2020; 135: 2033-2040
- 4 Beristain-Covarrubias N, Pérez-Toledo M, Thomas MR, Henderson IR, Watson SP, Cunningham AF. Understanding infection-induced thrombosis: lessons learned from animal models. Front Immunol 2019; 10: 2569
- 5 Goeijenbier M. Haemostasis and Virus Infections: Epidemiology, Pathogenesis and Prevention [DSc dissertation]. Rotterdam: Erasmus University; 2015
- 6 Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID-19. J Thromb Haemost 2020; 18: 1559-1561
- 7 Eizayaga FX. El moderno repertorio de Kent. Buenos Aires: Marecel; 1992
- 8 Kulthanan K, Cheepsomsong M, Jiamton S. Urticarial vasculitis: etiologies and clinical course. Asian Pac J Allergy Immunol 2009; 27: 95-102
- 9 Panigada M, Bottino N, Tagliabue P. et al. Hypercoagulability of COVID-19 patients in intensive care unit: a report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost 1738; 202: 18
- 10 Thachil J, Tang N, Gando S. et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost 2020; 18: 1023-1026
- 11 Zhang L, Yan X, Fan Q. et al. D-dimer levels on admission to predict in-hospital mortality in patients with COVID-19. J Thromb Haemost 2020; 18: 1324-1329
- 12 Holbrook A, Schulman S, Witt DM. et al. Evidence-based management of anticoagulant therapy: antithrombotic therapy and prevention of thrombosis. 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141: e152S-e184S
- 13 Kearon C, Akl EA, Ornelas J. et al. Antithrombotic therapy for venous thromboembolism: CHEST guideline and expert panel report. Chest 2016; 149: 315-352
- 14 Weitz JI, Fredenburgh JC, Eikelboom JW. A test in context: D-dimer. J Am Coll Cardiol 2017; 70: 2411-2420
- 15 Wang J, Hajizadeh N, Moore EE. et al. Tissue plasminogen activator (tPA) treatment for COVID-19 associated acute severe respiratory syndrome (ARDS): a case series. J Thromb Haemost 2020; 18: 1752-1755
- 16 Goyal A, Saigal S, Niwariya Y, Sharma J, Singh P. Successful use of tPA for thrombolysis in COVID related ARDS: a case series. J Thromb Thrombolysis 2020; 1-4
- 17 Choudhury S, Khuda-Bukhsh AR. Deep vein thrombosis cured by homeopathy: a case report. J Ayurveda Integr Med 2020; 11: 181-184
- 18 Whadwani GG. A case of deep vein thrombosis with post-thrombotic syndrome cured by homeopathic therapy. Ind J Res Homeopathy 2015; 9: 267-273
- 19 Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol 2020; 34: e212-e213
- 20 Freeman EE, McMahon DE, Lipoff JB. et al. The spectrum of COVID-19-associated dermatologic manifestations: an international registry of 716 patients from 31 countries. J Am Acad Dermatol 2020; 83: 1118-1129
- 21 Jamiolkowski D, Mühleisen B, Müller S, Navarini AA, Tzankov A, Roider E. SARS-CoV-2 PCR testing of skin for COVID-19 diagnostics: a case report. Lancet 2020; 396: 598-599
- 22 Waisse S, Oberbaum M, Frass M. The Hydra-headed coronaviruses: implications of COVID-19 for homeopathy. Homeopathy 2020; 109: 169-175
- 23 Guglielmetti G, Quaglia M, Sainaghi PP. et al. “War to the knife” against thromboinflammation to protect endothelial function of COVID-19 patients. Crit Care 2020; 24: 365
- 24 Ribes A, Vardon-Bounes F, Mémier V. et al. Thromboembolic events and Covid-19. Adv Biol Regul 2020; 77: 100735
- 25 Gris JC, Perez-Martin A, Quéré I, Sotto A. COVID-19 associated coagulopathy: the crowning glory of thromboinflammation concept. Anaesth Crit Care Pain Med 2020; 39: 381-382
- 26 Hering C. The Guiding Symptoms of Our Materia Medica. Vol. 1. Philadelphia, PA: The Homoeopathic Publishing Society; 1879
- 27 Choo YM, Lee KS, Yoon HJ. et al. Antifibrinolytic role of a bee venom serine protease inhibitor that acts as a plasmin inhibitor. PLoS One 2012; 7: e32269
- 28 Lee KS, Kim BY, Yoon HJ, Choi YS, Jin BR. Secapin, a bee venom peptide, exhibits anti-fibrinolytic, anti-elastolytic, and anti-microbial activities. Dev Comp Immunol 2016; 63: 27-35
- 29 Lee J, Park J, Yeom J, Han EH, Lim YH. Inhibitory effect of bee venom on blood coagulation via anti-serine protease activity. J Asia Pac Entomol 2017; 20: 599-604
- 30 Kalogeropoulos K, Treschow AF, auf dem Keller U. et al. Protease activity profiling of snake venoms using high-throughput peptide screening. Toxins (Basel) 2019; 11: 170
- 31 Chatterji RS, Roy ND. Disseminated intravascular coagulation following multiple bee stings (a case report). Med J Armed Forces India 1994; 50: 67-68
- 32 Jung JW, Jeon EJ, Kim JW. et al. A fatal case of intravascular coagulation after bee sting acupuncture. Allergy Asthma Immunol Res 2012; 4: 107-109
- 33 Vanamali DR, Bodepudi SK, Krishna M. Disseminated intravascular coagulation after multiple honeybee stings. Natl Med J India 2014; 27: 141-143