title: Hereditary and acquired thrombophilia in patients with upper extremity deep-vein thrombosis. Results from the MAISTHRO registry.
abstract: The prevalence of coagulation disorders in patients with upper extremity deep-vein thrombosis (UE-DVT) is unknown due to only a few observational studies of limited size reporting varying results. Therefore, we aimed to evaluate the prevalence of thrombophilia in patients with UE-DVT compared to patients with lower extremity deep vein thrombosis (LE-DVT). One hundred fifty consecutive patients (15 to 91 years of age) with UE-DVT were recruited from the MAISTHRO (MAin-ISar-THROmbosis) registry. Three hundred LE-DVT patients matched for gender and age served as controls. Thrombophilia screening included tests for the factor V Leiden mutation, the prothrombin G20210A mutation, antiphospholipid antibodies and factor VIII (FVIII), protein C, protein S and antithrombin activities. At least one thrombophilia was present in 34.2% of UE-DVT and 39.2% in UE-DVT that was unrelated to venous catheters relative to 55.3% in LE-DVT patients (p<0.001). In particular, a persistently elevated FVIII is less likely to be found in UE-DVT patients than in those with LE-DVT and is the only thrombophilia that is differentially expressed after controlling for established VTE risk factors [OR 0.46, (95% CI 0.25-0.83)]. Although less prevalent than in LE-DVT patients, thrombophilia is a common finding in patients with UE-DVT, especially in those with thrombosis that is unrelated to venous catheters.
authors.affiliation: J.W. Goethe University Hospital Frankfurt/Main, Division of Vascular Medicine, Department of Internal Medicine, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. Birgit.Linnemann@kgu.de
authors.forename: Birgit
authors.initials: B
authors.lastname: Linnemann
authors.forename: Florian
authors.initials: F
authors.lastname: Meister
authors.forename: Jan
authors.initials: J
authors.lastname: Schwonberg
authors.forename: Marc
authors.initials: M
authors.lastname: Schindewolf
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Zgouras
authors.forename: Edelgard
authors.initials: E
authors.lastname: Lindhoff-Last