Naslov
Cerebral venous sinus thrombosis as a recurrent thrombotic event in a patient with heterozygous prothrombin G20210A genotype after discontinuation of oral anticoagulation therapy: How long should we treat these patients with warfarin?

Autori
Jukić, Ivana ; Titlić, Marina ; Tonkić, Ante ; Rosezweig, Daniel

Izvornik
Journal of thrombosis and thrombolysis (0929-5305) 24 (2007), 1; 77-80

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
cerebral venous sinus thrombosis ; prothrombin gene G20210A mutation ; heterozygous ; warfarin anticoagulant therapy

Sažetak
Cerebral venous sinus thrombosis is an uncommon condition with many clinical manifestations, and hereditary prothrombotic conditions such as factor Leiden V, deficiency of protein S, protein C and antitrhrombin III, as well as prothrombin gene mutation, may account for 10-15% ofcases. To date, conflicting results have been reported for recurent venous thrombosis in the patients with factor V Leiden and prothrombin G20210A mutation, since some studies have shown a higher risk for recurrrent venous thrombosis in carriers of these two mutations than in non-carriers, and the last study showed higher risk only for carriers of double defect (hemozygous or double heterozygous for this mutations). We report a case of cerebral sinus thrombosis as a recurrent thrombotic event in a patient with heterozygous prothrombin G20210A genotype after discontinuation of oral anticoagulantion therapy. Since many facts are controversal, the use of secondary prophylaxis for thrombosis in these patients is still a matter of debate without clear consesus recommendation. Dateon the risk of recurrent thrombotic events in thrombophilic patient is insufficient. Tha main unclear question concerining these is: how long and whom should we treat with long-term anticoagulant therapy as secondary prophylaxis of DVT? The problem for practitioner is that we do not have guidelines and precise recommendations for secondary thromboprophylaxis in this or similar cases. This case is remarkable for its favorable and quick outcome and its rarity, because CSVT is an uncommon condition and heterozygous prothrombin G20210A genotype was only found predisposing factor for CSVT. Further tudies of risk of recurrent venous thrombosis in patients with heterozygous prothrombin G20210A genotype with the larger sample size are required.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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