acenocoumarol and Antithrombin-III-Deficiency

Topics: Acenocoumarol; Antithrombin III; Antithrombin III Deficiency; Drug Therapy, Combination; Female; Heparin; Humans; Pregnancy; Pregnancy Complications, Hematologic; Recurrence; Thrombophlebitis

This case report concerns a child admitted to the County Hospital of Zalaegerszeg with the symptoms of ataxia, focal convulsions and hemiparesis. Anticonvulsive therapy abolished the epileptic manifestations, but hemiparesis remained unchanged. At the age of six and half years progressive venous thrombosis developed first on the left and some days later on the right lower limb. Phlebography revealed on both sides thrombosis of the vena iliaca which led to stenosis of the right femoral vein and dilated venous collaterals on the abdomen and right thigh. Coeliacography showed an enlarged spleen and varicosity around the portal vein. Later thrombosis of the arteria dorsalis pedis developed indicated by the gangrene the fifth toe. At this stage the child was transfered to the Pediatric Department of the University of Pécs for further evaluation. Examination of the hemostasis showed hypercoagulability due to antithrombin III deficiency pointing towards a common cause, namely thromboembolism of the earlier and recent clinical manifestations. A reduced activity of the antithrombin III was also observed in the mother and two sisters of the child. The response to Syncumar therapy was beneficial, arterial thrombosis regressed and no further thromboembolic complications developed.

Topics: Acenocoumarol; Antithrombin III Deficiency; Ataxia; Blood Coagulation Disorders; Child; Epilepsies, Partial; Female; Hemiplegia; Humans; Radiography; Roma; Thrombophlebitis; Thrombosis

A significant decrease of plasma antithrombin III (AT III) levels, measured with four different biological and immunological methods, was found in 8 of 11 members of a Sicilian family (family DM) and in 3 of 14 members of a northern Italian family (family A). Different behaviour after oral anticoagulant treatment with acenocoumarin was seen in 2 long-term treated subjects. The propositus of family DM, who had had a long history of recurrent thrombosis, did not show any increase of AT III levels. A significant increase was, on the contrary, observed in the propositus of family A, who had suffered a recent thrombosis in a branch of the inferior mesenteric vein.

Topics: Acenocoumarol; Adult; Antithrombin III Deficiency; Female; Genes, Dominant; Humans; Italy; Male; Middle Aged; Pedigree; Thrombosis