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Thrombophilia in venous leg ulcers: a comparative study in early and later onset

Ana M Calistru1, Teresa Baudrier, Luciana Gonçalves

  • 1Department of Dermatology and Venereology, Hospital São João, EPE, Porto, Portugal. anagruia@yahoo.com

Indian Journal of Dermatology, Venereology and Leprology
|May 9, 2012
PubMed

Insights

Patients with early-onset chronic venous ulcers (CVU) exhibit a significantly higher thrombophilic risk, indicated by multiple thrombophilias. Early screening for thrombophilia in CVU patients under 50 is crucial for risk stratification and management.

Area of Science:

  • Vascular Medicine
  • Hematology
  • Genetics

Background:

  • Chronic venous ulcers (CVU) are associated with a high prevalence of thrombophilia, similar to deep vein thrombosis (DVT).
  • Patients developing CVU before age 50 represent a distinct clinical group regarding etiology, progression, and outcomes.

Purpose of the Study:

  • To compare thrombophilia prevalence and nature in early-onset CVU (before 50) versus late-onset CVU.
  • To identify specific thrombophilic factors associated with early-onset CVU.

Main Methods:

  • Clinical assessment and blood tests for thrombophilia markers in 27 early-onset and 27 late-onset CVU patients.
  • Testing included factor V Leiden, prothrombin G20210A, PAI-1 mutations, protein levels, and antiphospholipid antibodies.

Main Results:

  • All patients presented at least one thrombophilia. Early-onset CVU showed a significantly higher prevalence of multiple (≥3) thrombophilias (29.6% vs 7.4%) and homozygous mutations (P=0.03).
  • The PAI-1 4G/4G mutation was more common in early-onset cases. Higher, though not statistically significant, rates of Factor V Leiden, prothrombin G20210A, and antiphospholipid antibodies were observed in the early-onset group.

Conclusions:

  • Early-onset CVU is linked to a significantly elevated thrombophilic risk, characterized by multiple thrombophilias and homozygous mutations.
  • Thrombophilia screening in CVU patients under 50 is vital for risk stratification and guiding prophylactic and therapeutic strategies.
Abstract

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