title: Acute myocardial infarction, ischemic cerebrovascular disease and variceal bleeding due to portal vein thrombosis in a patient with hereditary thrombophilia.
abstract: We report on a 43-year-old female patient with multiple thrombotic risk factors who, in a few months, developed acute myocardial infarction, an ischemic cerebrovascular event and variceal bleeding due to portal vein thrombosis. The factor V Leiden mutation was carried in heterozygous form, homocysteine was elevated at 19.6 micromol/l, and methylenetetrahydrofolate reductase C677T mutation was carried in homozygous form. Moderately increased plasma homocysteine level and a reduced protein S activity were evident. Anticardiolipin IgG antibodies were mildly positive. We conclude that the presence of multiple genetic and environmental risk factors greatly amplifies the risk of clinical thrombotic events.
authors.affiliation: Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Baran
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yilmaz
authors.forename: Oktay
authors.initials: O
authors.lastname: Algin
authors.forename: Murat
authors.initials: M
authors.lastname: Keskin
authors.forename: Murat
authors.initials: M
authors.lastname: Kiyici
authors.forename: Guzin
authors.initials: G
authors.lastname: Kocamaz
authors.forename: Enver
authors.initials: E
authors.lastname: Dolar
mesh_terms: D000328:Adult; D005165:Factor V / Q000009:adverse effects*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D009203:Myocardial Infarction / Q000209:etiology; D011169:Portal Vein / Q000503:physiopathology; D020521:Stroke / Q000209:etiology; D019851:Thrombophilia / Q000235:genetics / Q000503:physiopathology*; D020246:Venous Thrombosis / Q000209:etiology / Q000235:genetics / Q000503:physiopathology*
chemical_list: C095381:factor V Leiden; D005165:Factor V; D042965:Methylenetetrahydrofolate Reductase (NADPH2)