cyproterone and Antithrombin-III-Deficiency

The authors report 3 personal cases of recurrent, strictly superficial phlebitis of the lower limbs which developed in young women and responded dramatically to corticosteroid therapy. The phlebitis was oestrogen dependent: it has started during pregnancy and was exacerbated in the second part of the menstrual cycle. Clinically, the disease presented as red, dilated veins and/or isolated inflammatory nodules mimicking acute nodular panniculitis. Histology confirmed the diagnosis by showing a major polymorphous inflammatory infiltrate in the venous wall and extending well beyond it, and an intraluminal occasionally occlusive thrombus. A search for thrombosis-inducing diseases, such as disorders of coagulation or fibrinolysis, connective tissue disease, neoplasia or infraction, was negative. Since the phlebitis was strongly inflammatory, frequently recurred and resisted numerous treatments, systemic corticosteroid therapy was instituted, resulting in a dramatic improvement. The steroids were then successfully replaced by antiplatelet agents or, because of the oestrogen dependence, cyproterone maleate. After a mean follow-up period of 2 years, the patients are doing well.

Topics: Adrenal Cortex Hormones; Adult; Antithrombin III Deficiency; Bacterial Infections; Contraceptive Agents, Female; Cyproterone; Female; Humans; Neoplasms; Pregnancy; Protein C Deficiency; Recurrence; Thrombophlebitis