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ORAL CONTRACEPTIVES ENHANCE THE RISK OF CLINICAL MANIFESTATION OF VENOUS THROMBOSIS AT A YOUNG AGE IN FEMALES HOMOZYGOUS FOR FACTOR V LEIDEN |
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| Authors: | Claudia,Rintelen Christine,Mannhalter Helen,Ireland David A.,Lane Paul,Knö bl Klaus,Lechner Ingrid,Pabinger |
| Affiliation: | First Department of Medicine, Division of Haematology and Blood Coagulation,;Department of Laboratory Medicine, Division of Molecular Biology, University of Vienna, Austria; Department of Haematology, Charing Cross Hospital and Westminster Medical School, Hammersmith, London, U.K. |
| Abstract: | In 29 patients (17 females) homozygous Arg 506 Gln mutation (FV Leiden) was identified. 25 had been investigated because of venous thromboembolism (VTE); four asymptomatic patients were found during family studies. The first VTE had occurred significantly earlier in females (median age [m] 26 years, range 17–49) than in males (m=38 years, range 21–82) ( P = 0.01). 12 females (80%) had taken oral contraceptives (OC, oestrogen content 0.02–0.1 mg) for 6–150 months prior to thrombosis. Further triggering conditions in females were hormone replacement ( n = 1) and pregnancy ( n = 2). In 8/10 males the first VTE had occurred spontaneously — in two after surgery. The sites of VTE were deep vein thrombosis, pulmonary embolism, caval vein thrombosis and superficial thrombophlebitis. From our data we conclude that OC medication is the most important precipitating factor for VTE in females with homozygous FV Leiden. |
| Keywords: | thrombophilia factor V Leiden APC resistance oral contraceptives venous thromboembolism |