Deep venous thrombosis and previous myocardial infarction in mild factor XII deficiency: a risk factor for both venous and arterial thrombosis.
Factor XII deficiency is associated with increased risk for both arterial and venous thrombosis. We describe a case of DVT involving superficial femoral and popliteal vein occurred following total hip replacement and despite prophylaxis with low molecular weight heparin in a subject with previous acute myocardial infarction (AMI). Tests of haemostasis documented a slightly prolonged activated partial thromboplastin time (APTT) (45'') due to mild factor XII deficiency (clotting activity 32%). A therapeutic dose of enoxaparin was started, together with warfarin therapy. The patient was advised to continue oral anticoagulation indefinitely. Although cases of both venous and arterial thrombosis in carriers of severe factor XII deficiency have been already reported, to our knowledge this is the first case in the literature occurred in a carrier of partial factor XII deficiency. In conclusion, factor XII deficiency should be suspected if a patient presents with recurrent arterial and/or venous thrombosis and prolonged APTT. If this defect is diagnosed, in the presence of a history of thrombotic events, lifelong anticoagulation could be considered.
Lessiani
Gianfranco
G
Villa Serena Hospital, Pescara, Italy. g.lessiani@libero.it
Falco
Angela
A
Nicolucci
Elvira
E
Rolandi
Giancarlo
G
Davì
Giovanni
G
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000209:etiology; D004562:Electrocardiography; D005175:Factor XII Deficiency / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology*; D010314:Partial Thromboplastin Time; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology; D020246:Venous Thrombosis / Q000209:etiology*