ISOLATED ILIAC VEIN-THROMBOSIS DURING ORAL-CONTRACEPTIVE THERAPY IN 3NORMAL WOMEN

Isolated iliac vein thrombosis appears to be a rare clinical entity. I t is usually due to extrinsic compression on the iliac vein with conse quent stasis. Diagnosis may be difficult since compression ultrasonogr aphy is usually negative. Only phlebography is surely diagnostic. This procedure should be carried out whenever there is a discrepancy betwe en the clinical evaluation and a negative sonography. We report three women on oral contraceptive therapy in whom a diagnosis of isolated il iac vein thrombosis was suspected clinically and confirmed phlebograph ically. No other congenital or acquired potential cause of thrombosis was present in the propositae but for the oral contraceptives. Oral co ntraceptives had been taken for 12, 3, and 2 months respectively for t hree patients before thrombosis occurred. Two of the propositae were 2 5 years old and the third was 54. The latter patient had been given or al contraceptives to ''prevent osteoporosis'' after menopause. The dis continuation of the pill together with usual heparin and coumarin ther apy were effective in every instance. A specific pathogenic role of th e oral contraceptives may be surmised. In fact, no isolated iliac vein thrombosis was found in a control group of 20 women of fertile age we showed to have idiopathic deep vein thrombosis of the legs. This arti cle emphasizes once again the importance of a careful clinical evaluat ion in the suspicion of deep vein thrombosis.