Hypercoagulable States in Primary Upper-Extremity Deep Vein Thrombosis

Héron, Emmanuel; Lozinguez, Olivier; Alhenc‐Gelas, Martine; Emmerich, Joseph; Fiessinger, Jean‐Noël

doi:10.1001/archinte.160.3.382

Cited by 106 publications

(105 citation statements)

References 17 publications

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“…In a series of 25 women with idiopathic UEDVT, one had received ovarian stimulation, 3 were pregnant (all through the first two months of pregnancy), and 11 were using oral contraceptives [7]. In our series, three patients were under hormonal treatment and 1 was in the second month of pregnancy, all having spontaneous UEDVT.…”

Section: Discussionmentioning

confidence: 66%

“…He´ron et al [7] also reported a high prevalence of hypercoagulable status in a population of patients with idiopathic UEDVT compared to those with effort-related UEDVT [42% (13/31) vs. 15% (3/20)]. Leebeek et al [21] recently found thrombophilic defects in 32% of their population with UEDVT and the most frequently found coagulation abnormality was the presence of antiphospholipid antibodies (27%).…”

Section: Discussionmentioning

confidence: 95%

“…Some of them also incorporated cases with effort-related UEDVT and the prevalence showed range from 8% to 61.1% [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Primary upper‐extremity deep vein thrombosis: High prevalence of thrombophilic defects

et al. 2004

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Primary deep venous thrombosis of the upper extremity (UEDVT) is an unusual disorder. Limited data are available on the contribution of hypercoagulable status in the pathogenesis of this disease. This study aims to report the prevalence of inherited and acquired thrombophilic risk factors (TF) in patients with primary (effort-related and spontaneous) UEDVT. From 1993 to 2002, 31 patients (17 females, median age 38.8 years, range 16-60 years; and 14 males, median age 31.4 years, range 20-56 years) with primary UEDVT (n = 15 effort-related and n = 16 spontaneous) were referred for screening of hypercoagulable status. Nineteen (61.3%) patients had at least one coagulation abnormality. The most common acquired TF were antiphospholipid antibodies (31% lupus anticoagulant and 12.9% anticardiolipin antibodies). Factor V Leiden (12.9%) and prothrombin G20210A mutation (20%) were the most prevalent genetic risk factors. Five patients (16.1%) had high plasma homocysteine levels, and one patient (4.7%) had protein S deficiency. Effortrelated UEDVT was associated with male gender (P = 0.04) and younger age (P = 0.02). There was no significant difference in the prevalence of acquired or inherited TF between patients with effort-related or spontaneous UEDVT. A local anatomic abnormality was detected in seven patients (22.5%), and the prevalence of TF was significantly lower within this group (P = 0.006). The incidence of TF in patients without an anatomic abnormality was 75% (RR 5.25). This study found a high prevalence of an underlying thrombophilic status in spontaneous and effort-related UEDVT. Hypercoagulable status may play a significant role in both groups. Screening for local anatomical abnormalities and thrombophilia should be included in the evaluation of primary UEDVT. Am.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 95%

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Primary upper‐extremity deep vein thrombosis: High prevalence of thrombophilic defects

et al. 2004

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“…In the present study on DVT of the upper extremity no patient with a prothrombin G20210A gene variant was identified. In the previous studies the prothrombin G20210A gene variant was not evaluated, with the exception of a subgroup of 37 patients in the study of Héron et al [15]. No prothrombin G20210A gene variant was detected in their study either.…”

Section: Discussionmentioning

confidence: 91%

“…The difference in prevalence of a hypercoagulable state in the reported studies [11,15,16,17] may in part be caused by a difference in patient population, due to a variance in selection of patients. Theoretically the number of coagulation abnormalities is expected to be higher in patients with DVTUE without other predisposing factors, so-called idiopathic or primary thrombosis.…”

Section: Discussionmentioning

confidence: 95%

Hypercoagulability states in upper‐extremity deep venous thrombosis

et al. 2001

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Deep venous thrombosis of the upper extremity (DVTUE) is a rare thrombotic disorder that may occur spontaneously but is most often related to predisposing factors, such as an indwelling central venous catheter, malignancy, or exercise. The role of coagulation disorders, i.e., a hypercoagulable state in the pathogenesis of DVTUE is not well known. We have evaluated both genetic and acquired thrombophilia parameters in consecutive patients with DVTUE. A hypercoagulable state was found in 32% of the patients. The most frequent coagulation abnormality was the presence of lupus anticoagulant or anticardiolipin antibodies (27%). Factor V Leiden mutation was detected in two patients, antithrombin deficiency in one, and none of the patients had the prothrombin G20210A gene variant or protein C or S deficiency. The prevalence of coagulation abnormalities was not significantly different in a subgroup of patients with spontaneous DVTUE as compared to those with an obvious predisposing factor, such as an indwelling central venous catheter. We conclude that antiphospholipid antibodies are frequently found in patients with DVTUE. Factor V Leiden mutation, prothrombin 20210A gene variant, protein C deficiency, and protein S deficiency do not seem to play a major pathogenetic role in DVTUE. Am. J. Hematol. 67:15-19, 2001.

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Hypercoagulability Syndromes

Thomas¹

2001

Archives of Internal Medicine

126

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Hypercoagulability can be defined as the tendency to have thrombosis as a result of certain inherited and/or acquired molecular defects. Clinical manifestations of hypercoagulability can be devastating and even lethal. In the past 20 years, the origin of most of these diverse hypercoagulability syndromes has been elucidated. Currently, hypercoagulability disorders can be correctly diagnosed in approximately 80% to 90% of patients. Defining the cause of hypercoagulability may determine the type and duration of treatment for the associated thrombosis. The discovery of an occult carcinoma allows for the possibility of early and possibly curative treatment. Finding a genetic defect in coagulation allows for testing of asymptomatic family members as well. The purpose of this review is to provide internists with a logical approach to the identification and treatment of hypercoagulability syndromes.

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Hypercoagulable States in Primary Upper-Extremity Deep Vein Thrombosis

Abstract: Hypercoagulable states appear to play a significant role in idiopathic but not in effort-related UEDVT.

Cited by 106 publications

References 17 publications

Primary upper‐extremity deep vein thrombosis: High prevalence of thrombophilic defects

Primary upper‐extremity deep vein thrombosis: High prevalence of thrombophilic defects

Hypercoagulability states in upper‐extremity deep venous thrombosis

Hypercoagulability Syndromes

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