Thrombosis involving the major veins with heterozygote factor V Leiden mutation as the only risk factor

A 27-year-old man was admitted to our hospital with the complaints of swell ing of his face and lower limbs. Echocardiography showed minimal pericardia l effusion accompanied by disordered diastolic function. Cardiac catheteriz ation was performed to rule out constrictive pericarditis. Normal pressure tracings of the right heart rule out constrictive pericarditis, however, a. narrowing of the inferior vena cava was observed. Venographies of the infe rior and superior vena cavae showed extensive thrombotic involvement of the se great veins. Protein C, protein S, anticardiolipin antibodies, fibrinoge n, antithrombin-III, activated protein C resistance, and factor V levels we re in normal limits. Heterozygosity for factor V Leiden mutation was detect ed. We conclude that factor V Leiden mutation can cause extensive thromboti c involvement of major veins and should be considered in idiopathic thrombo sis of them.