Acquired SERPINC1/antithrombin deficiency during oral contraceptive consumption: a case report.

Autor: Denora, D., Di Rosa, M. V., Altamura, N., Pellicori, F., Vinci, P., Sisto, U. G., Spanò, F., Di Girolamo, F. G., Fiotti, N., Biolo, G.
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Zdroj: Journal of Medical Case Reports; 7/28/2023, Vol. 17 Issue 1, p1-3, 3p
Abstrakt: Background: SERPINC1 is a glycoprotein that regulates blood coagulation. SERPINC1 congenital or acquired deficiencies represent a significant risk factor for thromboembolic disease. SERPINC1 acquired defects are observed in very few cases and can occur in many clinical conditions such as treatment with l-asparaginase or oral contraceptive (particularly estrogen derivatives), but these conditions are not routinely investigated. Case presentation: A 50-year-old Caucasian woman who took gestodene 75 µg/ethinylestradiol 20 µg as oral contraceptive, was sent to our thrombophilia clinic because, on thrombophilia testing, a reduction of SERPINC1 (74%) and a slight increase in circulating D-dimer and homocysteine were found. We investigated triggers of such SERPINC1 reduction, and identified gestodene 75 µg/ethinylestradiol 20 µg use as the most likely candidate. Two months after the discontinuation of the oral contraceptive, SERPINC1 value returned to normal (92%) and D-dimer and homocysteine were normalized. Conclusion: Each patient has a different sensitivity to contraceptive use. Genetic (or epigenetic) regulation of anticoagulant proteins might account for a different rate of consumption of anticoagulant proteins as oral contraceptives and probably determine the susceptibility to thrombotic events. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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