Hereditary and acquired thrombophilia in patients with upper extremity deep-vein thrombosis - Results from the MAISTHRO registry

Journal:Thrombosis and Haemostasis
ISSN:0340-6245
DOI:http://dx.doi.org/10.1160/TH08-03-0196
Issue:2008: 100/3 (Sep) pp. 365-516
Pages:440-446

Hereditary and acquired thrombophilia in patients with upper extremity deep-vein thrombosis - Results from the MAISTHRO registry

Birgit Linnemann, Florian Meister, Jan Schwonberg, Marc Schindewolf, Dimitrios Zgouras, Edelgard Lindhoff-Last
J.W. Goethe University Hospital, Division of Vascular Medicine, Department of Internal Medicine, Frankfurt/Main, Germany

Summary

The prevalence of coagulation disorders in patients with upper extremity deep-vein thrombosis (UE-DVT) is unknown due to only a few observational studies of limited size reporting varying results. Therefore, we aimed to evaluate the prevalence of thrombophilia in patients with UE-DVT compared to patients with lower extremity deep vein thrombosis (LE-DVT). One hundred fifty consecutive patients (15 to 91 years of age) with UE-DVT were recruited from the MAISTHRO (MAin-ISar- THROmbosis) registry. Three hundred LE-DVT patients matched for gender and age served as controls.Thrombophilia screening included tests for the factor V Leiden mutation, the prothrombin G20210A mutation, antiphospholipid antibodies and factor VIII (FVIII), protein C, protein S and antithrombin activities. At least one thrombophilia was present in 34.2% of UEDVT and 39.2% in UE-DVT that was unrelated to venous catheters relative to 55.3% in LE-DVT patients (p<0.001). In particular, a persistently elevated FVIII is less likely to be found in UE-DVT patients than in those with LE-DVT and is the only thrombophilia that is differentially expressed after controlling for established VTE risk factors [OR 0.46, (95% CI 0.25–0.83)]. Although less prevalent than in LE-DVT patients, thrombophilia is a common finding in patients with UE-DVT, especially in those with thrombosis that is unrelated to venous catheters.

Keywords

thrombophilia, factor VIII, malignancy, Upper extremity DVT, venous catheters

DOI

http://dx.doi.org/10.1160/TH08-03-0196

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