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Importance of lifelong oral anticoagulant therapy in adolescent with congenital thrombophillia
Abstract number: PP-WE-254
Jovic1 M., Redzic1 D., Serbic2 O., Aleksic1 D., Djokic1 D.
11Hemathooncology 22Transphusiology, Mother and Child Health Care Institute, New Belgrade, Serbia
How-to-cite Jovic M, Redzic D, Serbic O, Aleksic D, Djokic D. Importance of lifelong oral anticoagulant therapy in adolescent with congenital thrombophillia. Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract PP-WE-254
We are presenting a 17 years old male adolescent, who had been admitted in our hospital in September 2007, due to fever, pain and swelling of the left lower limb. Physical examination showed high fewer up to C39, stripped redness and swelling of the skin on the inner side of left leg, painful and warm, with reduced movement in left ankle. Family history was positive for thrombophillia. Patient's father died because of thrombotic event in mead forties. Laboratory findings, including complete blood count, coagulation screening tests were normal, screening for thrombophillia showed resistance of activating protein C. Color Doppler revealed thrombus in vena saphena magna. Therapy started with low molecular weight heparin and parenteral antibiotic. After 10 days we discharged LMWH and continue therapy with oral anticoagulant. Control ultrasound performed 14 days latter showed completely resolution of the thrombus so we preceded oral anticoagulant therapy for 3 months. In the meantime we obtained molecular and genetic analyses which shoved that the patient is heterozygote for FV Leiden and MTHFR C677T mutation. He received prophylaxis with low doses of acetylsalicylic acid from January to November 2008. Second episode of thrombophlebitis in the left popliteal vain occurred in April 2008. He was treated with LMWH until complete resolution of symptoms. In August 2008 we decided to start with continuous oral anticoagulant therapy for prevention thromboembolic complication, bur patient redrew therapy by himself. In January 2009, he developed third episode of thrombophlebitis in left lower limb, with regular ultrasonography finding and resolution of symptoms a few days after initiation of LMWH. This case shows the importance of introduction of lifelong per oral anticoagulant therapy even in adolescence, in patients who have documented congenital thrombophilia and at least one episode of tromboembolic event. This therapy reduces the risk of novel; potentially much more sever thrombotic complications. It is also important to recognize these conditions as soon as possible, because the prophylactic therapy gives the chance for more qualitative life and prevent potentially fatal complications.
Disclosure of interest: Grant/Research-Support.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
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