RECURRENT ARTERIAL THROMBOSIS WITH FACTOR V LEIDEN HOMOZYGOCY
Abstract number: P-S-201
Bradstreet1 C., Delatte2 P., Bosschaerts3 T., Alonso4 I., Cantinieaux4 B., Hermans1 P.
11Internal medicine 22Radiology 33vascular surgery 44hematologic laboratory, CHU Saint Pierre, Bruxelles, Belgium
How-to-cite Bradstreet C, Delatte P, Bosschaerts T, Alonso I, Cantinieaux B, Hermans P. RECURRENT ARTERIAL THROMBOSIS WITH FACTOR V LEIDEN HOMOZYGOCY. J Thromb Haemost 2007; 5 Supplement 2: P-S-201
Introduction: The influence of factor V Leiden on arterial circulation remains controversial.
Methods: A 39 years old previously healthy Romanian woman was admitted to the hospital because of an acute right arm pain. Physical examination showed pallor and coldness of the right arm with abolished peripheral pulses. An arteriography showed the presence of a thrombosis of the right subclavian artery nearby a cervical rib. The patient was successfully treated by thromboendarteriectomy and vitamin K antagonists were started.
Two months later, the patient was brought to the emergency room because she complained of vertigo and had collapsed. The vitamin K antagonists had been voluntary stopped for several weeks. The patient had motor aphasia. Further neurological examination showed a left sided paresis with a positive left Babinski sign. Computed tomographic (CT) scanner of the brain performed at the admission was normal. Echocardiography and 24 hour holter monitoring showed no emboligenous pathology. A magnetic resonance imaging study of the cerebral arteries showed a thrombosis of basilar and vertebral arteries.
Results: The thrombophilic screening demonstrated an abnormal activated protein C resistance test with a ratio of 1.33 (normal >2). Genetic study confirmed a homozygous mutation Arg506>Gln of the factor V gene.
Conclusions: In adult population, recent studies subgroup analyses of patients <55 years old and of women revealed slightly stronger associations between factor V Leiden and arterial thrombosis. Moreover, in a recent report, 15% of patients carrying homozygous mutations or combined thrombophilic defects had an arterial involvement.
These results indicate that young patients presenting arterial thrombosis should be screened for a thrombophilic disorder.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
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