Unilateral Leg Swelling and Liver Enzyme Elevation in an Adolescent.

Horner, Gabrielle; Luger, Grace; McGrath, Mary; Sharma, Anita; Bloom, David A; Shakhin, Victoria · Pediatrics · 2025

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Abstract

A previously healthy 15-year-old female developed sudden onset right lower extremity swelling, pain, and erythematous linear streaking from the ankle to mid-thigh. Duplex venous ultrasound revealed multiple superficial and deep venous thrombi in the right lower extremity. Incidentally, the patient was also noted to have elevated transaminases and a microcytic anemia with significant iron deficiency. Additional evaluation ultimately led to the diagnosis of 2 distinct but interconnected chronic conditions, one of which progressed to requiring liver transplantation.