COAGULATION-FACTOR-V GENE MUTATION ASSOCIATED WITH ACTIVATED PROTEIN-C RESISTANCE LEADING TO RECURRENT THROMBOSIS, LEG ULCERS, AND LYMPHEDEMA - SUCCESSFUL TREATMENT WITH INTERMITTENT COMPRESSION

Activated protein C resistance is the most frequent cause of venous th rombosis. We describe a patient with extensive ulcerations and severe lymphedema of the legs after recurrent thrombosis. Laboratory tests re vealed a pathologic activated protein C resistance and a reduced funct ional protein S. The underlying genetic defect was identified as a het erozygous coagulation factor V mutation. A combined therapeutic approa ch of intermittent compression, repeated debridements and systemic ant ibiotics resulted in marked improvement of both lymphedema and leg ulc ers.