THROMBOEMBOLIC DISEASE DEVELOPING DURING ORAL-CONTRACEPTIVE THERAPY IN YOUNG FEMALES WITH ANTIPHOSPHOLIPID ANTIBODIES

The role of oral contraceptives as a triggering factor for thrombosis in patients with lupus anticoagulant (LA) and/or anticardiolipin antib odies (ACA) has not yet been established. We describe the cases of thr ee women aged 19, 29 and 48 years who developed venous thrombosis afte r 16+/-3.4 (mean+/-SD) cycles of oral contraceptives. They were all as ymptomatic before taking the pill. Two patients subsequently developed venous and/or arterial recurrence of thrombosis. Laboratory studies p erformed after the diagnosis of thrombosis, showed the presence of LA and elevated levels of ACA (IgG and IgM) in all three patients. None o f these patients had autoimmune diseases and therefore appeared to hav e a primary antiphospholipid antibody syndrome. The three patients bel onged to a group of 45 young females who experienced their first throm botic event while taking the pill. This group had a similar prevalence (8%) for antithrombin deficiency and antiphospholipid antibodies. We surmise that some of the women who developed venous thrombosis while t aking the pill might have an undetected primary antiphospholipid syndr ome.