Methylene tetrahydrofolate reductase gene mutation together with anticardiolipin antibody during pregnancy: a case report.
BACKGROUND
High plasmatic homocysteine levels have been associated with arterial and venous thrombosis. The C677T methylene tetrahydrofolate reductase (MTHFR) gene mutation is one of the known causes for high homocysteine levels in plasma. Anticardiolipin antibody (ACA) is also associated with thrombosis and, along with other clinical complications such as recurrent abortion and stillbirth, is part of the antiphospholipid syndrome.


METHODS
Case report.


METHODS
A 19-year-old woman with two gestations and one parity (G2P1) had exhibited deep venous thrombosis in her previous puerperal period. Investigation of thrombophilic factors revealed ACA-IgM and heterozygous C677T mutation in the MTHFR gene. Lupus anticoagulant, protein C, protein S and antithrombin III deficiencies, and Leiden factor V and the G20210A mutation in the prothrombin gene, were not detected. The patient received 55,000 IU of subcutaneous heparin daily, from the 15th to the 36th week of pregnancy, when vaginal delivery took place. There were no clinical complications during the puerperal period and she was discharged three days after delivery, while still using oral anticoagulants.
Couto
Egle
E
Departamento de Ginecologia e Obstetrícia, Universidade Estadual de Campinas, São Paulo, Brazil. egle@unicamp.br
Barini
Ricardo
R
Nomura
Marcelo Luís
ML
Annichino-Bizzacchi
Joyce Maria
JM
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D000925:Anticoagulants / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control*
D017153:Antibodies, Anticardiolipin; D000925:Anticoagulants; D006493:Heparin; D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2)