Venous thromboembolism after hip fracture surgery in a patient with haemophilia B and factor V Arg506Gln (factor V Leiden)

We describe a patient with mild haemophilia B who developed symptomatic ven ous thromboembolism after hip arthroplasty for a traumatic fracture, A deep vein thrombosis developed in the operated leg while he was receiving a hig h-purity factor IX concentrate. Subsequently, he was determined to be a het erozygous carrier for the factor V Arg506Gln (Leiden) mutation. This case i llustrates the importance of providing thromboprophylaxis for all patients with haemophilia receiving coagulation factor replacement and who undergo s urgical procedures known to be associated with a high risk of venous thromb oembolism. In patients with haemophilia and a family history of venous thro mboembolism, preoperative screening for the presence of the factor V Arg506 Gln mutation and other thrombophilias may be useful.