Ischemic colitis and acquired resistance to activated protein C in a woman using oral contraceptives.
We present the case history of a 22-yr-old woman diagnosed with ischemic colitis associated with the use of oral contraceptives (OC). At the time of her presenting symptoms activated protein C (APC) resistance, a risk factor for thrombosis, was demonstrated. There was no laboratory evidence of inherited thrombophilia; that is, antithrombin III, protein C and protein S levels were normal and the factor V Leiden mutation was not present. The OC were discontinued and the patient's symptoms improved. Subsequent evaluation revealed that the activated protein C resistance had resolved. This case illustrates APC resistance as a potential link between OC use and its known association with ischemic colitis.
Department of Medicine, College of Medicine, University of Florida, Gainesville 32610, USA.
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Mann
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Kessel
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Mullins
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Lottenberg
D000328:Adult; D001780:Blood Coagulation Tests; D017091:Colitis, Ischemic / Q000097:blood / Q000139:chemically induced*; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D019304:Ethinyl Estradiol-Norgestrel Combination / Q000009:adverse effects*; D005165:Factor V / Q000235:genetics; D005260:Female; D006801:Humans; D009154:Mutation; D011486:Protein C / Q000502:physiology
D003277:Contraceptives, Oral, Combined; D011486:Protein C; C095381:factor V Leiden; D019304:Ethinyl Estradiol-Norgestrel Combination; D005165:Factor V