title: APC resistance as an additional thrombotic risk factor in a patient suffering from polycythemia vera and recurrent thrombosis.
abstract: Patients with polycythemia vera (PV) have a high risk of thrombosis. However, thrombosis is not sufficiently predictable with standard diagnostic procedures. We report on a patient with PV and recurrent thrombosis who nevertheless had a low platelet count while under therapy with hydroxyurea. As a result of duodenal ulcer and gastrointestinal bleeding, treatment with phenprocoumon was stopped years ago. Recently, heterozygosity for the factor V gene defect was diagnosed and anticoagulation therapy was reconsidered. In conclusion, the presence of resistance to activated protein C was an additional thrombotic risk factor that was important for our decision to change the treatment strategy in our patient.
authors.affiliation: Department of Internal Medicine, University of Marburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Lamparter
authors.forename: M
authors.initials: M
authors.lastname: Schuermann
authors.forename: H H
authors.initials: HH
authors.lastname: Heidtmann
mesh_terms: D004351:Drug Resistance; D004789:Enzyme Activation; D005165:Factor V / Q000235:genetics; D006410:Hematopoiesis / Q000187:drug effects; D006579:Heterozygote; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010976:Platelet Count / Q000187:drug effects; D011087:Polycythemia Vera / Q000150:complications*; D011486:Protein C / Q000378:metabolism* / Q000494:pharmacology*; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications* / Q000453:epidemiology*
chemical_list: D011486:Protein C; D005165:Factor V; D006918:Hydroxyurea