title: Thrombophilic factors in idiopathic intracranial hypertension: a report of 51 patients and a meta-analysis.
abstract: Several studies have suggested that thrombophilic risk factors are more prevalent in individuals with idiopathic intracranial hypertension (IIH), and that a prothrombic state may be involved in the etiopathogenesis of this disease. We examine thrombophilic factors in a group of patients with IIH in relation to obesity. In addition, we reviewed the relevant literature and performed a meta-analysis. Thrombophilia work-up was performed on 51 patients with IIH at least 1 month following their first episode. Samples for the analysis of factor V Leiden (FVL), prothrombin gene variant (PGV) G20210A and methylenetetrahydrofolate reductase (MTHFR) were available in an additional 30 patients, that is 81 patients in all. Meta-analysis was performed. Of the 51 patients 40 were obese. Increased concentrations of fibrinogen, D-Dimer, factor VIII, factor IX and factor XI were found in 15, 7, 7, 6 and 2 patients, respectively, all obese. The circulating anticoagulant, measured by dilute Russell's viper venom time (dRVVT assay), found mainly in obese. All 51 patients were negative for the anticardiolipin antibody (IgG immunoglobulin G) and IgG anti-beta2 glycoprotein I. In the meta-analysis antiphospholipid antibodies were significantly associated with IIH [odds ratio (OR) of 4.25 (1.68-12.60)], similar to the association with high factor VIII [OR = 16.17 (2.87-91.01)], higher plasminogen activator inhibitor-1 (PAI-1) levels [OR = 6.91 (2.28-20.91)], and high lipoprotein (a) [LP(a)] [OR = 3.54 (1.54-8.70)]. Obesity often observed in IIH patients is frequently linked with thrombophilic factors. Thus, we believe that dysmetabolism could be the thrombophilic target for treatment in patients with IIH.
authors.affiliation: Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Israel. kesler@netvision.net.il <kesler@netvision.net.il>
authors.forename: Anat
authors.initials: A
authors.lastname: Kesler
authors.forename: Efrat
authors.initials: E
authors.lastname: Kliper
authors.forename: Einor Ben
authors.initials: EB
authors.lastname: Assayag
authors.forename: Eti
authors.initials: E
authors.lastname: Zwang
authors.forename: Varda
authors.initials: V
authors.lastname: Deutsch
authors.forename: Uriel
authors.initials: U
authors.lastname: Martinowitz
authors.forename: Aharon
authors.initials: A
authors.lastname: Lubetsky
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D005165:Factor V / Q000235:genetics; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D005342:Fibrinolysis; D014644:Genetic Variation; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011516:Prothrombin / Q000235:genetics; D011559:Pseudotumor Cerebri / Q000097:blood* / Q000150:complications* / Q000209:etiology; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications*; D055815:Young Adult
chemical_list: D017152:Antibodies, Antiphospholipid; D017270:Lipoprotein(a); C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin; D005169:Factor VIII; D042965:Methylenetetrahydrofolate Reductase (NADPH2)