title: Upper extremity deep vein thrombosis after suspension of progesterone-only oral treatment.
abstract: The intake of steroid hormone contraceptives is a strong and independent risk factor for venous thromboembolism. Several studies have assessed an increased risk of venous thromboembolism in women using oral contraceptives who are carriers of the G20210A mutation in the prothrombin gene. Most trials evaluating the thrombotic risk of oral contraceptives are based on combined oral preparations, but only a few focus on progestogen-only oral preparations. Results from such studies are conflicting and globally assess the thrombotic risk, ranging from modest to slightly increased. Furthermore, little is known about the relationship between the C677T mutation in the methylenetetrahydrofolate reductase gene and the progestogen-based preparations. Herewith we report the case of a 49-year-old woman with a complex genetic thrombosis risk factor who had taken oral progesterone for 15 months without any complication, but then experienced severe left upper extremity deep vein thrombosis 2 months after the drug suspension.
authors.affiliation: Centro Emofilia e Trombosi, Unità Operativa Medicina Interna 2, Ematologia, Università de L'Aquila, Ospedale San Salvatore, L'Aquila, Italy. emofilia.aq@cc.univaq.it
authors.forename: Mario
authors.initials: M
authors.lastname: Lapecorella
authors.forename: Assunta
authors.initials: A
authors.lastname: Orecchioni
authors.forename: Luigi
authors.initials: L
authors.lastname: Dell'Orso
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Mariani
mesh_terms: D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D008875:Middle Aged; D017354:Point Mutation; D011374:Progesterone / Q000008:administration & dosage / Q000009:adverse effects*; D011516:Prothrombin / Q000235:genetics; D012307:Risk Factors; D013997:Time Factors; D034941:Upper Extremity / Q000098:blood supply; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000201:enzymology / Q000235:genetics*
chemical_list: D003278:Contraceptives, Oral, Hormonal; D011374:Progesterone; D011516:Prothrombin; D042965:Methylenetetrahydrofolate Reductase (NADPH2)