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Recurrent Deep Vein Thrombosis due to Thrombophilia.

Rahman A, Islam AM, Husnayen S - Korean Circ J (2012)

Bottom Line: Investigations revealed protein C and protein S deficiency.Protein C, protein S and antithrombin deficiency either singly or in combination, are relatively common causes of hereditary thrombophilia.The case presented here serves as a reminder of the need to look into the underlying cause of venous thromboembolism.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh.

ABSTRACT
Deep vein thrombosis (DVT) is a common condition that is often under-diagnosed. Acquired or hereditary defects of coagulation or a combination of these defects may facilitate the development of DVT. Recurrent DVT, a positive family history or unusual presentation may warrant investigation for hereditary thrombophilia. Investigations are best when conducted at least one month after completion of a course of anticoagulant therapy. Most patients are managed with heparin in the acute stage overlapped by warfarin. The case presented here describes a 40-year old man undergoing three episodes of DVT. Investigations revealed protein C and protein S deficiency. Protein C, protein S and antithrombin deficiency either singly or in combination, are relatively common causes of hereditary thrombophilia. The case presented here serves as a reminder of the need to look into the underlying cause of venous thromboembolism.

No MeSH data available.


Related in: MedlinePlus

Normal pulmonary arteries shown on the CT angiogram.
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Figure 4: Normal pulmonary arteries shown on the CT angiogram.

Mentions: A duplex study of the lower limb vessels showed acute DVT involving the left femoro-popliteal segment. CT angiography revealed normal pulmonary arteries (Fig. 4). Blood sugar, renal and liver function tests, serum electrolytes and calcium were normal. A haemogram including platelet count, urinalysis, chest radiograph and echocardiography revealed normal findings. A compliment fixation test for filaria was negative. Because of the recurrence of venous thromboembolism (VTE), it was decided to search for any coagulation abnormality. Therefore, the blood coagulation profile was studied four weeks after the onset of DVT. Platelet count, bleeding time, clotting time and prothrombin time (PT) were normal. In addition, plasma fibrinogen and homocysteine levels were within normal range, and antithrombin activity in the blood was also normal. Conversely, the protein C activity was 58% (normal range: 70-140%), and the protein S activity was greatly reduced to 17% (normal range: 54-137%). Ideally, coagulation assay should be conducted one month after completion of a course of anticoagulation, but considering the number and frequency of recurrence of DVT, and associated risks of life-threatening complications like pulmonary thromboembolism, anticoagulant therapy was not stopped.


Recurrent Deep Vein Thrombosis due to Thrombophilia.

Rahman A, Islam AM, Husnayen S - Korean Circ J (2012)

Normal pulmonary arteries shown on the CT angiogram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369967&req=5

Figure 4: Normal pulmonary arteries shown on the CT angiogram.
Mentions: A duplex study of the lower limb vessels showed acute DVT involving the left femoro-popliteal segment. CT angiography revealed normal pulmonary arteries (Fig. 4). Blood sugar, renal and liver function tests, serum electrolytes and calcium were normal. A haemogram including platelet count, urinalysis, chest radiograph and echocardiography revealed normal findings. A compliment fixation test for filaria was negative. Because of the recurrence of venous thromboembolism (VTE), it was decided to search for any coagulation abnormality. Therefore, the blood coagulation profile was studied four weeks after the onset of DVT. Platelet count, bleeding time, clotting time and prothrombin time (PT) were normal. In addition, plasma fibrinogen and homocysteine levels were within normal range, and antithrombin activity in the blood was also normal. Conversely, the protein C activity was 58% (normal range: 70-140%), and the protein S activity was greatly reduced to 17% (normal range: 54-137%). Ideally, coagulation assay should be conducted one month after completion of a course of anticoagulation, but considering the number and frequency of recurrence of DVT, and associated risks of life-threatening complications like pulmonary thromboembolism, anticoagulant therapy was not stopped.

Bottom Line: Investigations revealed protein C and protein S deficiency.Protein C, protein S and antithrombin deficiency either singly or in combination, are relatively common causes of hereditary thrombophilia.The case presented here serves as a reminder of the need to look into the underlying cause of venous thromboembolism.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh.

ABSTRACT
Deep vein thrombosis (DVT) is a common condition that is often under-diagnosed. Acquired or hereditary defects of coagulation or a combination of these defects may facilitate the development of DVT. Recurrent DVT, a positive family history or unusual presentation may warrant investigation for hereditary thrombophilia. Investigations are best when conducted at least one month after completion of a course of anticoagulant therapy. Most patients are managed with heparin in the acute stage overlapped by warfarin. The case presented here describes a 40-year old man undergoing three episodes of DVT. Investigations revealed protein C and protein S deficiency. Protein C, protein S and antithrombin deficiency either singly or in combination, are relatively common causes of hereditary thrombophilia. The case presented here serves as a reminder of the need to look into the underlying cause of venous thromboembolism.

No MeSH data available.


Related in: MedlinePlus