title: Lower extremity venous thrombosis in patients younger than 50 years of age.
abstract: OBJECTIVE
  Lower extremity deep venous thrombosis in the young adult is uncommon and has not been well studied in the literature. The aim of this study is to define risk factors for deep venous thrombosis among patients younger than 50 years of age, to compare them with a control group, and to suggest recommendations for the management and treatment of venous thrombosis in this particular group of patients.
  
  
  METHODS
  From January 2003 to January 2011, 66 consecutive Lebanese patients (29 males and 37 females) younger than 50 years, diagnosed in an academic tertiary-care center with lower extremity deep venous thrombosis by color flow duplex scan, were retrospectively reviewed. Their age varied between 21 and 50 years (mean 38.7 years). The control group included 217 patients (86 males and 131 females) older than 50 years (range: 50-96 years; mean 72.9 years).
  
  
  RESULTS
  The most commonly reported risk factors in the younger age group were inherited thrombophilia (46.9% compared with 13.8% in the control group; P < 0.001), pregnancy (18.2% compared with 0.5%; P < 0.001), treatment with estrogen drugs (13.6% compared with 2.3%; P = 0.001), and family history of venous thromboembolism (9.1% compared with 3.8%; P = 0.084).
  
  
  CONCLUSIONS
  Inherited thrombophilia is the most commonly observed risk factor among patients younger than 50 years, with a prevalence of three times more than the control group. Young adults should be screened for thrombophilia even in the presence of transient acquired risk factors. Pregnancy and treatment with estrogen drugs essentially when associated with inherited thrombophilia represent a frequent cause of venous thrombosis among young female patients. Inferior vena cava abnormalities should be excluded in young patients with spontaneous proximal venous thrombosis especially when recurrent venous thrombosis or resistance to anticoagulation are observed.
authors.affiliation: Department of Vascular Surgery, Saint George Hospital, University Medical Center, University of Balamand, Beirut, Lebanon. docrkdy@inco.com.lb
authors.forename: Raghid
authors.initials: R
authors.lastname: Kreidy
authors.forename: Pascale
authors.initials: P
authors.lastname: Salameh
authors.forename: Mirna
authors.initials: M
authors.lastname: Waked
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D004967:Estrogens / Q000009:adverse effects; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color; D054079:Vascular Malformations / Q000453:epidemiology; D020246:Venous Thrombosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal; D004967:Estrogens