Comparison of inherited and acquired thrombophilia in cerebral venous thrombosis and pulmonary embolism or deep vein thrombosis of the leg

Abstract number: P1695

Martin-Toutain^* I., Favier‡ R., Jacob^* N., Vu^* T., Couty^* M. C., Ankri^* A.

^*Pitie Salpetriere Hospital, France; ‡Trousseau Hospital, Paris, France

Cerebral venous thrombosis (CVT) is an infrequent condition with a large variety of causes. However in 20–35% of cases, no cause is found. In this study we compared a group of patients with CVT with a group of patients with pulmonary embolism (PE) and one with deep vein thrombosis of the leg (LVT) in term of age, sex and frequency of inherited thrombophilia. The acquired causes of thrombosis such as postpartum and use of oral contraceptive (CO) or hormone replacement therapy (HRT) were also considered. In this retrospective study, 254 patients with antecedent of single episode of deep vein thrombosis were included 1–20 years after thrombosis. The patients were separated in three groups: antecedent of CVT diagnosed by angiography and/or MRI (n = 32), antecedent of PE diagnosed by angioCTscan (n = 65) and antecedent of LVT diagnosed by Doppler ultrasonography or venography (n = 157). Coagulation studies included: anti-thrombin (AT), protein C (PC), protein S (PS), factor VIII (FVIII) and prothrombotic polymorphism including G1691A factor V leiden (FVL), G20210A Prothrombin (PT20210A) and C677T homozygosity for thermolabile methylenetetrahydrofolate reductase (MTHFR-T). Results are given in Table 1. There was a significantly difference (P = 0.04) between the age of patients with CVT and patients with PE. The frequency of inherited or acquired causes of thrombosis was not significantly different in the three groups. In the group CVT, thrombosis occurred in young patients; use of CO or HRT was present in 62.5% of females and inherited thrombophilia was found in 62.5% of patients. This suggests that these abnormalities should be looked for in all patients with CVT. The detection of such abnormalities has major practical consequences on the long-term management of patients to prevent further episodes.

Table 1