Hypercoagulable states in primary upper-extremity deep vein thrombosis

Background: There are very few data on the prevalence of coagulation abnorm alities in primary deep vein thrombosis of the upper limbs. Objective: To determine if coagulation abnormalities play a role in effort- related and/or idiopathic (non-effort-related) upper-extremity deep vein th rombosis (UEDVT). Methods: Fifty-one consecutive patients (21 men and 30 women) who had effor t-related (n = 20) or idiopathic (n = 31) UEDVT over an 18-year period (med ian age at diagnosis, 32 years; age range, 15-86 years) were routinely reex amined. Plasma was screened for antithrombin, protein C, and protein S defi ciencies and for antiphospholipid antibodies (lupus anticoagulant and antic ardiolipin antibodies). The DNA was screened for factor V Leiden and for pr othrombin gene G20210A mutations. Results: The median age (35 vs 28 years), the proportion of women (81% [25/ 31] vs 25% [5/20]), the proportion of patients with a personal and/or famil y history of thromboembolism (42%; [13/31] vs 15% [3/20]), and the proporti on of patients with at least 1 coagulation abnormality (42% [13/31] vs 15% [3/20]) were higher in the idiopathic UEDVT group than in the effort-relate d UEDVT group. The odds ratio of having a coagulation abnormality was 4.09 (95% confidence interval, 0.99-16.78; P = .06) in the idiopathic UEDVT grou p compared with the effort-related UEDVT group. Conclusion: Hypercoagulable states appear to play a significant role in idi opathic but not in effort-related UEDVT.