title: Factor V Leiden mutation in postthrombotic and non-postthrombotic venous ulcers.
abstract: OBJECTIVE
  To determine the prevalence of the factor V Leiden mutation in patients with postthrombotic and non-postthrombotic venous ulcers.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
  
  
  METHODS
  Seventy-three consecutive outpatients and inpatients with venous ulcers and 45 age- and sex-matched control subjects (matched to the 42 patients with postthrombotic syndrome).
  
  
  METHODS
  Frequency of postthrombotic and non-postthrombotic findings in patients with venous ulcers. Prevalence of the factor V Leiden mutation in these different subgroups.
  
  
  RESULTS
  Postthrombotic syndrome was identified as the cause of 42 (58%; 95% confidence interval [CI], 45%-69%) of 73 venous ulcers, and the remainder were caused by primary valvular insufficiency. In postthrombotic ulcers, the prevalence of the factor V Leiden mutation was 38% (95% CI, 24%-54%) (16/42), which corresponds to an odds ratio of 13.2 (95% CI, 2.8-62.3; P<.001). In non-postthrombotic venous ulcers, the prevalence was 16% (95% CI, 5%-34%) (5/31), which corresponds to an odds ratio of 3.2 (95% CI, 1.0-10.0; P =.07).
  
  
  CONCLUSIONS
  The factor V Leiden mutation is highly prevalent in patients with postthrombotic venous ulcers. Even patients with non-postthrombotic venous ulcers show a moderately elevated prevalence of the factor V Leiden mutation. Some of the latter might be misclassified because of near-to-perfect revascularization after asymptomatic deep venous thrombosis. However, as long as the therapeutic consequences of the factor V Leiden mutation are not established, systematic screening cannot be recommended in patients with venous ulcers.
authors.affiliation: Department of Dermatology, University Hospital of Zurich, CH-8091 Zurich, Switzerland. jhafner@derm.unizh.ch
authors.forename: J
authors.initials: J
authors.lastname: Hafner
authors.forename: A
authors.initials: A
authors.lastname: Kühne
authors.forename: B
authors.initials: B
authors.lastname: Schär
authors.forename: T
authors.initials: T
authors.lastname: Bombeli
authors.forename: M
authors.initials: M
authors.lastname: Hauser
authors.forename: R
authors.initials: R
authors.lastname: Lüthi
authors.forename: E
authors.initials: E
authors.lastname: Hänseler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005165:Factor V / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D013927:Thrombosis / Q000150:complications*; D014647:Varicose Ulcer / Q000209:etiology* / Q000235:genetics*
chemical_list: C095381:factor V Leiden; D005165:Factor V