Hereditary Spherocytosis (HS) Associated with a Heterozygous MTHFR C677T Mutation and with Elevated Anticardiolipin Antibodies
| Autor: | Mark M. Landeros, Maria Velazquez, Juan Herrada, Luis S. Noble, Anuradha Gupta |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Pregnancy
medicine.medical_specialty Thrombocytosis biology Anemia business.industry Immunology Cell Biology Hematology medicine.disease Biochemistry Thrombosis Gastroenterology Hereditary spherocytosis Venous thrombosis Internal medicine Methylenetetrahydrofolate reductase medicine biology.protein Family history business |
| Zdroj: | Blood. 114:5069-5069 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood.v114.22.5069.5069 |
| Popis: | Abstract 5069 Background Hereditary spherocytosis (HS) is a spectrum of inherited erythrocyte membrane defects that result in hemolysis and varying degrees of anemia, usually not associated with increased thrombotic risk. However, there is some concern about post-splenectomy thrombocytosis, since both arterial and venous thromboembolic events have been reported in patients splenectomized for HS. A review of the medical literature revealed only a few cases of thrombosis associated with pregnancy and hereditary spherocytosis, and none of them had methyl tetrahydrofolate reductase (MTHFR) mutations or the presence of elevated anticardiolipin antibodies (both considered risk factors for thromboembolic disease). Methods Case report Results A 34-year-old Caucasian female with history of hereditary spherocytosis and splenectomy at age five, underwent evaluation for infertility. The patient was found to have a high titer of anticardiolipin antibodies and the presence of heterozygosity for the MTHFR C677T mutation. She denied any personal or family history of deep venous thrombosis. Subsequently the patient became pregnant. Because the combination of thrombophilic states appears to increase the risk of thromboembolic events, it was decided to start the patient prophyllactically with oral aspirin 81 mg daily, Foltx® (Folic acid 2.5 mg, cyanocobalamin 2000 mcg, and pyridoxine hydrochloride 25 mg), and heparin 5000 mg subcutaneously twice a day. On her most recent evaluation, at 26 weeks of pregnancy, no medical or obstetric problems have been observed. Conclusion Our case illustrates an unusual combination of thrombophilic states. Further studies are needed to evaluate the clinical significance of this association. Disclosures No relevant conflicts of interest to declare. |
| Databáze: | OpenAIRE |
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