Venous thromboembolism after hip fracture surgery in a patient with haemophilia B and factor V Arg506Gln (factor V Leiden).
We describe a patient with mild haemophilia B who developed symptomatic venous thromboembolism after hip arthroplasty for a traumatic fracture. A deep vein thrombosis developed in the operated leg while he was receiving a high-purity factor IX concentrate. Subsequently, he was determined to be a heterozygous carrier for the factor V Arg506Gln (Leiden) mutation. This case illustrates the importance of providing thromboprophylaxis for all patients with haemophilia receiving coagulation factor replacement and who undergo surgical procedures known to be associated with a high risk of venous thromboembolism. In patients with haemophilia and a family history of venous thromboembolism, preoperative screening for the presence of the factor V Arg506Gln mutation and other thrombophilias may be useful.
Pruthi
R K
RK
Comprehensive Hemophilia Center, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Heit
J A
JA
Green
M M
MM
Emiliusen
L M
LM
Nichols
W L
WL
Wilke
J L
JL
Gastineau
D A
DA
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D005164:Factor IX / Q000008:administration & dosage / Q000009:adverse effects*; D005165:Factor V / Q000235:genetics; D002836:Hemophilia B / Q000150:complications* / Q000235:genetics / Q000601:surgery*; D006620:Hip Fractures / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D020246:Venous Thrombosis / Q000209:etiology* / Q000235:genetics
C095381:factor V Leiden; D005165:Factor V; D005164:Factor IX