[Value of an extensive biological study in venous or arterial thromboses].
OBJECTIVE
The aim of this work is to study the signification of an extensive biological evaluation in patients with "unexplained" thrombosis. We studied 78 patients with more than one arterial and/or venous thromboembolic event.


METHODS
Fifty-four patients were admitted for unexplained deep venous thrombosis (group I, n = 19, 9 men and 10 women) and/or arterial thrombosis (group II, n = 35, 21 men and 14 women). A third group (group III) included 24 patients (13 men, 11 women) known to have a pathologic state which can lead to a thrombotic event.


RESULTS
The patients in both groups I and II had, more often than normal subjects, a high level of homocysteinemia (26% vs 3%, p < 0.001), anti-beta 2 glycoprotein 1 (18.5% vs 3%, p < 0.001) and antiphospholipid antibodies (13% vs 3%, p < 0.02). We also found a significant association between an increase of erythrocytic aggregation and arterial thrombosis (group II). In the third group, for both arterial (n = 14) and venous (n = 10) thrombosis, we found a high level of anticardiolipin antibodies (25% vs 3%, p < 0.001), anti-beta 2 glycoprotein 1 antibodies (12.5% vs 3%, p < 0.05) and abnormal erythrocytic aggregation (16.5% vs 3%, p < 0.01). In these 3 groups the other studied parameters (Lp(a), platelet aggregation, cryoglobulin, cryofibrinogen, antinuclear antibodies, anticytoplasm antibodies, plasma and urine immunoelectrophoresis, protein C, protein S, antithrombin III, plasminogen) were not different from levels observed in normal subjects.


CONCLUSIONS
An extensive biological analysis, including plasma homocystein level, anticardiolipin antibodies, anti-beta 2 glycoprotein 1 antibodies and a study of the erythrocytic aggregation would appear to be of value in patients presenting recurrent arterial or venous thromboembolic events. Specific therapy can be applied in case of abnormal results continued anticoagulant therapy for anticardiolipin and anti-beta 2 glycoprotein 1 antibodies, and a vitamin therapy for increased homocysteinemia.
Tazi
Z
Z
Service de Médecine interne, Hôpital Pitié-Salpêtrière, Paris.
Cacoub
P
P
Koskas
F
F
Chabanel
A
A
Chadefaux-Vekemans
B
B
Horellou
M H
MH
Viard
J P
JP
Piette
J C
JC
Kieffer
E
E
Godeau
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000032:analysis; D017152:Antibodies, Antiphospholipid / Q000032:analysis; D001053:Apolipoproteins; D004903:Erythrocyte Aggregation; D005069:Evaluation Studies as Topic; D005260:Female; D006023:Glycoproteins / Q000276:immunology; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood* / Q000209:etiology / Q000276:immunology; D053482:beta 2-Glycoprotein I
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D001053:Apolipoproteins; D006023:Glycoproteins; D053482:beta 2-Glycoprotein I; D006710:Homocysteine
Intérêt d'une exploration biologique approfondie au cours des thromboses veineuses ou artérielles.