CASE REPORTS   

International Angiology 2000 December;19(4):369-72

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

Extensive deep vein thrombosis in a young woman. Case report

De Backer T., Voet J. *, De Buyzere M. *, Vertongen P. **, Tsjoen G. ***, Duprez D. *, Clement D. *

From the Department of Cardiology, Dijkzigt Ziekenhuis, Erasmus University, Rotterdam, The Netherlands * Department of Cardiology-Angiology, University Hospital, Ghent University, Ghent, Belgium ** Department of Cardiology, Onze Lieve Vrouw Ziekenhuis, Waregem, Belgium *** Department of Endocrinology, University Hospital, Ghent University, Ghent, Belgium

We ­report a ­case of a ­young ­lady ­with an exten­sive ­deep ­vein throm­bo­sis (­DVT) diag­nosed by CT ­scan ­and ­duplex ultra­sound exam­ina­tion. Contributory fac­tors ­were rel­a­tive immo­bil­isa­tion, ­oral con­tra­cep­tion ­and hyper­hom­o­cys­tei­ne­mia ­after methi­o­nine load­ing. No oth­er throm­bo­phil­ic fac­tors ­could be ­found. The ­three ­main caus­es of hyper­hom­o­cys­tei­ne­mia ­are genet­ic ­defects, nutri­tion­al defi­cien­cies ­and insuf­fi­cient elim­i­na­tion. In ­our ­case a genet­ic ­defect ­for ­one of ­the ­key ­enzymes of homo­cys­teine metab­olism, ­may be ­the under­ly­ing ­cause. Besides stop­ping ­oral con­tra­cep­tive ­drugs, anti­co­ag­u­la­tion ­and sup­ple­men­ta­tion ­with pyri­dox­ine ­and ­folate ­was start­ed. Family screen­ing ­was car­ried ­out ­and ­revealed oth­er mem­bers ­with hyper­hom­o­cys­tei­ne­mia.
Whether ther­a­py ­with pyri­dox­ine ­and ­folate ­can sub­stan­tial­ly ­reduce ­the recur­rence of ­venous throm­boem­bol­ic dis­ease ­remains to be estab­lished.