Lipoprotein(a), Thrombophilia and Venous Thrombosis

Lippi, Giuseppe; Targher, Giovanni; Franchini, Massimo

doi:10.1159/000100932

Cited by 8 publications

(8 citation statements)

References 13 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By a negative spinal-cranial pressure gradient, this hypotension might at the same time lead to venous endothelial traumatic damage from stretching of the cerebral vessels or to a stasis of the blood flow via venous dilatation, again possibly provoking the development of a central nervous thrombosis [ 9 , 13 ]. Another important aspect is the fact that our patient carried a heterozygous mutation for factor II G20210A and a rather high lipoprotein A serum level, two factors known to increase the risk for thrombosis [ 14 , 15 ]. The importance of hereditary and acquired prothrombotic disorders has been emphasized in recent series of paediatric CVT [ 1 , 6 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Postdural Puncture Superior Sagittal Sinus Thrombosis in a Juvenile Case of Clinically Isolated Syndrome

Michel

Haberlandt

Baumann

et al. 2015

Case Reports in Pediatrics

View full text Add to dashboard Cite

Background. The causes of cerebral venous thrombosis (CVT) are manifold as is its clinical presentation.Case. We report the case of a CVT following lumbar puncture and intravenous glucocorticosteroid therapy in a female adolescent with a clinically isolated syndrome and risk factors for thrombosis.Conclusion. In adolescent patients with acute inflammatory disease undergoing lumbar puncture followed by intravenous high-dose glucocorticosteroid therapy, one should be aware of the elevated risk for thrombosis. A persistent headache with change in the headache pattern and loss of a postural component might be a sign for CVT, requiring emergency imaging of the brain.

show abstract

Section: Discussionmentioning

confidence: 99%

Postdural Puncture Superior Sagittal Sinus Thrombosis in a Juvenile Case of Clinically Isolated Syndrome

Michel

Haberlandt

Baumann

et al. 2015

Case Reports in Pediatrics

View full text Add to dashboard Cite

show abstract

“…8,10 Activation of the coagulation system in HSP has been suggested by some investigators, and elevations of factor VIII activity, homocysteine, and the presence of antiphospholipid antibodies have been cited in some cases. Evaluation for a definable hypercoagulable state demonstrated elevated lipoprotein A and factor VIII activity levels at presentation, both of which represent prothrombotic influences.…”

Section: Discussionmentioning

confidence: 99%

Crossing the Thrombotic Threshold

Zaidi

Berman

2014

Clin Pediatr (Phila)

View full text Add to dashboard Cite

A 10-year-old male with a past medical history of attention deficit hyperactivity disorder presented with a 1-day history of acute left calf pain. Four weeks prior to admission, evanescent nonpruritic, nonerythematous nickelsize lower extremity nodules were noted following a transient nonspecific viral illness. Five days prior to development of calf pain, he was diagnosis with Henoch-Schönlein purpura (HSP) when he developed scattered nonthrombocytopenic lower extremity petechiae and mild abdominal discomfort. No specific therapy was prescribed. On the day of admission, he had been sitting stationary at a sporting event for 3 hours prior to the sudden onset of left calf pain, progressing to limp and swelling. There was no history of trauma. Family history was significant for the patient's mother experiencing 5 first trimester spontaneous abortions. She subsequently received heparin treatment during a future successful pregnancy. Further details of her evaluation were not available, although she recalled being told that she "might have a lupus anticoagulant." On arrival at the emergency department, laboratory studies where performed (Table 1), and lower extremity venous Doppler study demonstrated acute deep vein thrombosis of the left peroneal vein. Enoxaparin sodium therapy was initiated (1 mg/kg q12hr SQ) and he was admitted for further management. Petechial rash and extremity symptoms and signs readily improved over the next several days.An extensive evaluation initiated for hypercoagulability was completed. Studies are listed in Table 2.Genetic studies for factor V Leiden and prothrombin gene mutation were unremarkable; the patient was found to be doubly heterozygous for MTHFR C677T and MTHFR A1298C (with normal homocysteine level).Enoxaparin was discontinued after 3 months when a repeat Doppler study demonstrated complete resolution of thrombosis. At 2-month follow-up, factor VIII remained mildly elevated at 154%; lipoprotein A was elevated at 85.8 mg/dL. At 9-month follow-up, the child remained well. DiscussionHSP is a well-characterized, multisystem, self-limited small vessel vasculitis mainly affecting children. The

show abstract

“…When exposed to strong shearing forces, such as those present in the pulmonary arteries, Lp(a) undergoes a shift from a close conformation to a fully extended chain, whereby its thrombogenic potential is dramatically amplified. 24 This structural modification is instead less unlikely to occur in the veins, where the blood flow is less perturbed.…”

Section: Discussionmentioning

confidence: 99%

The Thrombophilic Pattern of Different Clinical Manifestations of Venous Thromboembolism: A Survey of 443 Cases of Venous Thromboembolism

Grifoni

Marcucci

Ciuti

et al. 2012

Semin Thromb Hemost

View full text Add to dashboard Cite

Although pulmonary embolism (PE) and deep vein thrombosis (DVT) share many risk factors, it is uncertain whether thrombophilic abnormalities may impact differently on the development of these two clinical manifestations of venous thromboembolism (VTE). To give further insight into this issue, we estimated the association of PE with different types of thrombophilia and evaluated whether these abnormalities have a different prevalence in patients presenting with PE, alone or associated with DVT, as compared with those with isolated DVT. In this study 443 consecutive patients with a first episode of VTE and 304 matched healthy controls underwent laboratory screening for thrombophilia, including natural anticoagulants, factor V Leiden and prothrombin G20210A polymorphisms, antiphospholipid antibodies, homocysteine, factor VIII, and lipoprotein(a). Of the 443 patients, 224 patients had isolated DVT, 144 had combined DVT/PE, and 75 had isolated PE. At least one thrombophilic abnormality was detected in 72.8% of DVT, 66% of DVT/EP, and 60% of isolated PE patients. A high prevalence of hyperhomocysteinemia and elevated lipoprotein(a) levels was found in all patients with no significant differences among the three groups. The prevalence of prothrombin G20210A polymorphism and of elevated factor VIII levels was significantly higher in patients with DVT and DVT/PE than in controls, but not in those with isolated PE, whereas factor V Leiden polymorphism was associated with isolated DVT but not with DVT/PE or isolated PE. In conclusion, the thrombophilic burden seems different in isolated PE versus DVT with or without PE, suggesting that PE may encompass a different pathophysiological process of thrombosis to DVT.

show abstract

Lipoprotein(a), Thrombophilia and Venous Thrombosis

Cited by 8 publications

References 13 publications

Postdural Puncture Superior Sagittal Sinus Thrombosis in a Juvenile Case of Clinically Isolated Syndrome

Postdural Puncture Superior Sagittal Sinus Thrombosis in a Juvenile Case of Clinically Isolated Syndrome

Crossing the Thrombotic Threshold

The Thrombophilic Pattern of Different Clinical Manifestations of Venous Thromboembolism: A Survey of 443 Cases of Venous Thromboembolism

Contact Info

Product

Resources

About