Hypercoagulability states in upper-extremity deep venous thrombosis

Deep venous thrombosis of the upper extremity (DVTUE) is a rare thrombotic disorder that may occur spontaneously but is most often related to predispo sing factors, such as an indwelling central venous catheter, malignancy, or exercise. The role of coagulation disorders, i.e., a hypercoagulable state in the pathogenesis of DVTUE is not well known. We have evaluated both gen etic and acquired thrombophilia parameters in consecutive patients with DVT UE. A hypercoagulable state was found in 32% of the patients. The most freq uent coagulation abnormality was the presence of lupus anticoagulant or ant icardiolipin antibodies (27%). Factor V Leiden mutation was detected in two patients, antithrombin deficiency in one, and none of the patients had the prothrombin G20210A gene variant or protein C or S deficiency. The prevale nce of coagulation abnormalities was not significantly different in a subgr oup of patients with spontaneous DVTUE as compared to those with an obvious predisposing factor, such as an indwelling central venous catheter. We con clude that antiphospholipid antibodies are frequently found in patients wit h DVTUE. Factor V Leiden mutation, prothrombin 20210A gene variant, protein C deficiency, and protein S deficiency do not seem to play a major pathoge netic role in DVTUE. Am. J. Hematol. 67:15-19, 2001. (C) 2001 Wiley-Liss, I nc.