Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case report
Abstract Combined oral contraceptives and factor V Leiden mutation are multiplicative risk factors for venous thromboembolism. However, it remains unknown whether this multiplicative effect is reflected in thrombin generation assays. We report here the evolution of the thrombin generation profile wh...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-03-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rth2.12318 |
| _version_ | 1797727695772057600 |
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| author | Maxime G. Zermatten Debora Bertaggia Calderara Alessandro Aliotta Lorenzo Alberio |
| author_facet | Maxime G. Zermatten Debora Bertaggia Calderara Alessandro Aliotta Lorenzo Alberio |
| author_sort | Maxime G. Zermatten |
| collection | DOAJ |
| description | Abstract Combined oral contraceptives and factor V Leiden mutation are multiplicative risk factors for venous thromboembolism. However, it remains unknown whether this multiplicative effect is reflected in thrombin generation assays. We report here the evolution of the thrombin generation profile while taking combined oral contraceptives and after their discontinuation in a woman with heterozygous factor V Leiden mutation. The proband exhibited a distinctly prothrombotic thrombin generation profile including markedly decreased thrombomodulin (TM) sensitivity, compared to the control population. This profile possibly reflected a high thrombotic risk. After discontinuation of combined oral contraceptives, thrombin generation and TM sensitivity improved greatly, leaving only a slightly prothrombotic profile. Therefore, the multiplied thrombotic risk occurring with simultaneous combined oral contraceptives and factor V Leiden mutation is reflected by a thrombin generation assay performed without and with TM. This could be a promising tool to identify women taking combined oral contraceptives at high risk for venous thromboembolism. Further studies are needed to verify this hypothesis. |
| first_indexed | 2024-03-12T11:03:13Z |
| format | Article |
| id | doaj.art-2a961a74015d4f84861e79a3e51877fd |
| institution | Directory Open Access Journal |
| issn | 2475-0379 |
| language | English |
| last_indexed | 2024-03-12T11:03:13Z |
| publishDate | 2020-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj.art-2a961a74015d4f84861e79a3e51877fd2023-09-02T04:26:48ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792020-03-014342943210.1002/rth2.12318Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case reportMaxime G. Zermatten0Debora Bertaggia Calderara1Alessandro Aliotta2Lorenzo Alberio3Division of Haematology and Central Haematology Laboratory Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandDivision of Haematology and Central Haematology Laboratory Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandDivision of Haematology and Central Haematology Laboratory Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandDivision of Haematology and Central Haematology Laboratory Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandAbstract Combined oral contraceptives and factor V Leiden mutation are multiplicative risk factors for venous thromboembolism. However, it remains unknown whether this multiplicative effect is reflected in thrombin generation assays. We report here the evolution of the thrombin generation profile while taking combined oral contraceptives and after their discontinuation in a woman with heterozygous factor V Leiden mutation. The proband exhibited a distinctly prothrombotic thrombin generation profile including markedly decreased thrombomodulin (TM) sensitivity, compared to the control population. This profile possibly reflected a high thrombotic risk. After discontinuation of combined oral contraceptives, thrombin generation and TM sensitivity improved greatly, leaving only a slightly prothrombotic profile. Therefore, the multiplied thrombotic risk occurring with simultaneous combined oral contraceptives and factor V Leiden mutation is reflected by a thrombin generation assay performed without and with TM. This could be a promising tool to identify women taking combined oral contraceptives at high risk for venous thromboembolism. Further studies are needed to verify this hypothesis.https://doi.org/10.1002/rth2.12318contraceptionfactor Vthrombinthromboembolismthrombosisvenous |
| spellingShingle | Maxime G. Zermatten Debora Bertaggia Calderara Alessandro Aliotta Lorenzo Alberio Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case report Research and Practice in Thrombosis and Haemostasis contraception factor V thrombin thromboembolism thrombosis venous |
| title | Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case report |
| title_full | Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case report |
| title_fullStr | Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case report |
| title_full_unstemmed | Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case report |
| title_short | Thrombin generation in a woman with heterozygous factor V Leiden and combined oral contraceptives: A case report |
| title_sort | thrombin generation in a woman with heterozygous factor v leiden and combined oral contraceptives a case report |
| topic | contraception factor V thrombin thromboembolism thrombosis venous |
| url | https://doi.org/10.1002/rth2.12318 |
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