Venous Thromboembolism in Young Female While on Oral Contraceptives: High Frequency of Inherited Thrombophilia and Analysis of Thrombotic Events in 400 Czech Women

Dulíček, Petr; Malý, J; Pecka, M; Beránek, M.; Čermáková, Eva; Malý, Radován

doi:10.1177/1076029608325544

Cited by 18 publications

(23 citation statements)

References 25 publications

(28 reference statements)

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“…the most frequent inherited risk factor in our setting was factor v leiden mutation, which is consistent with other studies in our region (8,17). the mean number of risk factors was 2.6 in our patients, the multifactorial etiology of childhood vte was observed in other studies (16).…”

Section: Inherited Risk Factorssupporting

confidence: 93%

Venous Thromboembolism in Adolescents

Samková

Lejhancová

Hak

et al. 2012

Acta Med. (Hradec Kralove, Czech Repub.)

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The incidence of venous thromboembolism (VTE) during childhood is low with two peaks – neonatal and adolescent age. This retrospective study is focused on clinical characteristics of VTE during adolescence. The main goals are to assess the most frequent inherited and acquired risk factors and to evaluate the benefit of D-dimers in diagnostics of venous thromboemblism. The data of 18 adolescents were analysed – 16 girls (88.9%), 2 boys (11.1%). In 9 patients (50%) thrombosis of the lower limb deep veins was diagnosed, six patients (33.3%) suffered from symptomatic pulmonary embolism (PE) and 3 patients (16.7%) from thrombosis at unusual sites. One patient had an idiopathic VTE, the mean number of the inherited and acquired risk factors was 2.6. The most frequent inherited risk factor was Leiden mutation of factor V (27.8%). The most frequent acquired risk factor was oral contraception (OC) in 12 out of 16 girls (75%). All of our patients on oral contraception had one or more additional risk factors. 10 out of 18 (55.6%) patients with VTE had elevated activity of factor VIII. The sensitivity of D-dimers was low (50%) in patients with distal lower limb thrombosis, but very high (100%) in patients with PE.

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Section: Inherited Risk Factorssupporting

confidence: 93%

Venous Thromboembolism in Adolescents

Samková

Lejhancová

Hak

et al. 2012

Acta Med. (Hradec Kralove, Czech Repub.)

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“…Anticardiolipin antibody is also now recognized as an important cause of thrombosis [16][17][18]. Screening for these congenital thrombophilic factors as well as anticardiolipin antibody should be performed in patients having sporadic or recurrent thrombosis [19][20][21]. The use of oral contraceptive pill is a common risk factor for venous thromboembolism in women of reproductive age and surgical operations and pregnancy remain important triggers [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40].…”

Section: Pathogenesismentioning

confidence: 99%

“…The use of oral contraceptive pill is a common risk factor for venous thromboembolism in women of reproductive age and surgical operations and pregnancy remain important triggers [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Prolonged immobility as in long-haul flights and hormonal influences, such as the contraceptive pill, are also well-documented risk factors [9,20,21].…”

Section: Pathogenesismentioning

confidence: 99%

“…The risk of VTE in women with factor V Leiden is 5-6 fold higher in pregnancy [20]. The prevalence of different inherited thrombophilia in the general population and in patients with VTE and its calculated relative risk (RR) are summarized in Table 1.…”

Section: Congenital Risk Factors For Dvt (Thrombophilia)mentioning

confidence: 99%

“…Deficiency of physiological anticoagulant factors include deficiency of antithrombin (AT), Protein C (PC) or Protein S (PS), or heparin cofactor II. Combined deficiencies of Factor V Leiden, PC, PS, AT or the prothrombin mutation G20210A have been frequently described and they lead to a higher risk of thrombosis (20). There is an important interaction of Factor V and Factor II that leads to true synergistic potentiation with other transient risk factors for VTE such as pregnancy and oral contraceptives (12.20).…”

Section: Congenital Risk Factors For Dvt (Thrombophilia)mentioning

confidence: 99%

See 2 more Smart Citations

Complete Compression Ultrsonography, Clinical Score, Underlying Risk

Michiels¹,

Strijkers²,

Michiels³

et al. 2015

J Hematol Thrombo Dis

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Primary Superficial Thrombophlebitis (SVT)The incidence of superficial thrombophlebitis (SVT) is approximately 1.6 per 1000 persons per year. Several studies have confirmed the association of SVT and VTE. In a systematic review of patients with SVT, 6% to 44% of cases was associated with deep vein thrombosis (DVT), 20% to 33% with asymptomatic pulmonary embolism (PE) and 2% to 13% with symptomatic PE. Assessment of risk factor in the MEGA study a history of clinical SVT was associated with a 6.3-fold risk of DVT and a 3.9 risk of PE. In a study of 263 SVT patients, 30 (11.4%) developed DVT. Among 125 patients with SVT located in the great saphena vein, 16.8% developed DVT. Out of 138 patients with isolated SVT below the knee only 4.5% developed DVT. In a lower limb ultrasound study in 2646 patients 36 (9.3%) of the patients had combined DVT and PTS. These data indicate that primary SVT should be considered an integral part of DVT. The presence of inherited hypercoagulability or venous thrombophilia in both SVT and DVT strongly supports a similar etiology and pathphysiology. In… patients with primar SVT hereditary protein C and s deficiency was detected in 6.45% in the absence of DVT and in 62.5% in SVT patient who had developed DVT. In our experience hereditary heterozygous antithrombin defiencoiency (AT) is associated with a high risk on DVT and PE not preceded by SVT. Congenital protein C (PC) or protein S (PS) deficiency in 27 DVT patients (15 males, 12 females) in 6 unrelated Dutch families had a history of SVT 19 cases (70%) as the hall mark of congenital PC/PS deficiency. The prevalence of FV Leiden, FII A20210 mutation, and PC or PS deficiency in 63 evaluated SVT patients was 16%, 906% and 10% respectively (total 36%) as compared to 3%, 2.4% and 0.6% in 537 controls. The incidence of inherited thrombophilic risk factors in patients with a first DVT is high (31%) as compared to 5 to 6% in the general population (Table 1). In 1668 patients with a first DVT in the Leiden prospective study the incidence of congenital thrombophilia was 25%. In this study 417 (25%) of 1668 patients with a first DVT were on oral contraceptives below the age of 50 years. In 400 Czech young women with VTE on oral contraceptives (distal DVT 58%, proximal DVT 16%, PE 5%, thrombosis at unusual sites 20%) inherited thrombophilia was diagnosed in 195 (49%): FV Leiden 35% FIIA20210 mutation 5%,AT,PC PS deficiency 3.6% and antiphopholipid syndrome 5.3%. We conclude that thrombophilia screening is manadatory in SVT and DVT patients and in women on contraceptive pills in particular for the education of clinicians abling them to much better counsel their SVT and DVT patients and their relatives. AbstractSuperficial vein thrombosis is an integral part of venous thromboembolism (VTE) together with deep vein thrombosis (DVT) and pulmonary embolism (PE). The incidence of SVT is 1.6 per 1000 persons per year. The incidence of DVT is about 1.0 per 1000 persons per year in the general population, 1.8 per 1000 persons per year at age 65 to 69 years...

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Deep Vein Thrombosis in Athletes: Prevention and Treatment

Altıntaş

Uluçay

2011

Sports Injuries

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Venous Thromboembolism in Young Female While on Oral Contraceptives: High Frequency of Inherited Thrombophilia and Analysis of Thrombotic Events in 400 Czech Women

Cited by 18 publications

References 25 publications

Venous Thromboembolism in Adolescents

Venous Thromboembolism in Adolescents

Complete Compression Ultrsonography, Clinical Score, Underlying Risk

Deep Vein Thrombosis in Athletes: Prevention and Treatment

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