Klovaite Jolanta, Friis-Hansen Lennart, Larsen Fin S, Toffner-Clausen Nielsaage, Bjerrum Ole W
Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Denmark.
Blood Coagul Fibrinolysis. 2010 Apr;21(3):285-8. doi: 10.1097/MBC.0b013e3283370166.
Most clotting factor VII (FVII)-deficient patients suffer from bleeding episodes and occasionally thromboembolic complications after surgical interventions or replacement therapy. However, thromboses without apparent triggering factors may occur as well. We report a case of a pregnant woman with inherited FVII deficiency and chronic vena porta thrombosis. She presented at 32 weeks of gestation with spontaneously increased international normalized ratio, severe thrombocytopenia and very few unspecific symptoms. The extensive examination of the patient revealed cavernous transformation of the portal vein with well expressed portosystemic collaterals, heterozygosity for three common polymorphisms in FVII gene, associated with reduction in plasma FVII levels, and no other factors predisposing to thrombosis.
大多数凝血因子VII(FVII)缺乏的患者在手术干预或替代治疗后会出现出血发作,偶尔还会出现血栓栓塞并发症。然而,也可能发生无明显触发因素的血栓形成。我们报告一例患有遗传性FVII缺乏症和慢性门静脉血栓形成的孕妇病例。她在妊娠32周时出现国际标准化比值自发升高、严重血小板减少症且仅有极少的非特异性症状。对该患者的全面检查显示门静脉海绵样变性,伴有明显的门体侧支循环,FVII基因中三种常见多态性的杂合性,这与血浆FVII水平降低有关,且无其他易导致血栓形成的因素。