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Causes of venous thrombosis in fifty Chinese patients
1Division of Hematology, Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China. chho@vghtpe.gov.tw
Insights
Malignancy and protein S deficiency were the most frequent causes of venous thrombosis in Chinese patients. Further research is needed to identify risk factors in nearly half of the cases studied.
Area of Science:
- Hematology
- Thrombosis Research
- Genetics
Background:
- Venous thrombosis is a significant clinical concern.
- Identifying underlying causes is crucial for effective management and prevention.
- Previous studies have explored various risk factors, but data specific to the Chinese population is limited.
Purpose of the Study:
- To investigate the prevalence of acquired and congenital risk factors for venous thrombosis in a Chinese patient cohort.
- To determine the most common causes of venous thrombosis within this specific demographic.
Main Methods:
- Prospective study of 50 consecutive patients with confirmed venous thrombosis.
- Comprehensive laboratory testing for coagulation disorders, thrombophilia, and genetic mutations.
- Inclusion of tests for antithrombin, protein C, protein S, lupus anticoagulant, anticardiolipin antibody, and MTHFR gene mutations.
Main Results:
- Malignancy was identified in 10% of patients.
- Protein S deficiency was the most frequent congenital cause (8%).
- No cases of Factor V Leiden or prothrombin 20210 A allele mutations were found.
- A significant proportion (48%) of patients had no identifiable risk factor.
Conclusions:
- Malignancy is the leading acquired cause of venous thrombosis in this Chinese population.
- Protein S deficiency is the most common congenital risk factor.
- The etiology of venous thrombosis remains unexplained in a substantial number of patients, highlighting the need for further investigation.
Abstract:
In a whole year from July 1997 to June 1998, a total of 50 patients with sonogram-proved venous thrombosis who called on our hematology clinic consecutively entered into the study. Their mean age was 59.1 +/- 17.5 years, range 18-83 years, and 29 were male. A series of examinations were performed in order to find out the cause of venous thrombosis. These examinations included antithrombin, protein C, protein S, plasminogen, heparin cofactor II, activated protein C ratio, factor V Leiden mutation, fibrinogen, factors VIII and XII, euglobulin lysis time, 677 C-->T mutation of methylenetetrahydrofolate reductase (MTHFR), prothrombin 20210 (PT 20210) A allele mutation, lupus anticoagulant, anticardiolipin antibody, and complete blood count. Five patients (10%) were found to have malignancy; an inferior vena cava thrombosis in one patient was due to venous compression by hydronephrosis; two patients had lupus anticoagulant; two had varicose veins of legs; two had protein C deficiency; four had protein S deficiency; two had plasminogen deficiency; two had antithrombin deficiency. No activated protein C resistance, elevated factor VIII level, factor V Leiden, PT 20210 A allele or heparin cofactor II deficiency was found in the present study. Homozygous MTHFR 677 C-->T gene mutation was found in 7 patients (14%); one of them also had a plasminogen deficiency. No possible risk factor of venous thrombosis could be found in 24 patients (48%). In conclusion, malignancy and protein S deficiency were the most frequent acquired and congenital causes of venous thrombosis in the Chinese, respectively.