Pathogenetic factors underlying juvenile deep vein thrombosis (DVT) in Indians.
The role of hereditary antithrombotic protein defects in juvenile deep vein thrombosis (DVT) was evaluated. Fifty six young patients (age <45 yr) with doppler-proven DVT were investigated for the presence of resistance to activated protein C (APC-R), lupus anticoagulant (LA), anticardiolipin antibodies and deficiencies of protein C, protein S, ATIII activities. Fifty nine normal healthy individuals served as controls. APC-R was observed to be the commonest defect underlying the Indian DVT as seen in 39.2% of patients followed by elevated ACA (5.3%), PAI (2.8%), presence of LA (2.8%) and reduced ATIII levels (2.8%). None of the subjects had protein C or S deficiency. APC-R was associated with ATIII deficiency in one case, and elevated ACA in two cases. In two subjects, APC-R was associated with elevated PAI levels. Patients with more than one prothrombotic factor had a higher prevalence of pulmonary thromboembolism, suggesting that the thrombogenic potential of APC-R is enhanced by the presence of coexisting hereditary or acquired prothrombotic defect.
Department of Haematology, All India Institute of Medical Sciences, New Delhi. renusax@medinst.ernet.in
R
R
Saxena
S
S
Mohanty
A
A
Srivastava
V P
VP
Choudhry
J
J
Kotwal
D020016:Activated Protein C Resistance / Q000150:complications / Q000235:genetics; D000293:Adolescent; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D016682:Lupus Coagulation Inhibitor / Q000032:analysis; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000032:analysis; D020151:Protein C Deficiency / Q000150:complications / Q000235:genetics; D018455:Protein S Deficiency / Q000150:complications / Q000235:genetics; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics
D017153:Antibodies, Anticardiolipin; D016682:Lupus Coagulation Inhibitor; D017395:Plasminogen Activator Inhibitor 1