PB0578 - Antithrombin deficiency responsible for repeated thromboembolic complications – case report

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

Lucia Stančiaková, MD, PhD. (she/her/hers)

physician-researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Co-Author(s)

PH

Pavol Holly

physician-hematologist
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
Kristína Vajdová, MD, PhD.

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
IS

Ivan Sámel

physician-internist
Department of Orthopedics, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
Ingrid Skornova, Ing.

Laboratory diagnostician
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
JI

Jela Ivanková

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
Jana Zolkova, DSc, PhD (she/her/hers)

laboratory researcher
National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Slovakia
Martin, Zilina, Slovakia
�V

Ľubica Vadelová

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia 2Center of Hemostasis and Thrombosis - Unilabs Slovakia, s. r. o., Martin, Slovakia
Martin, Zilina, Slovakia
TB

Tomáš Bolek

physician-internist
Department of Internal Medicine I, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
MS

Matej Samoš

university professor
Department of Internal Medicine I, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
PK

Peter Kubisz

university professor
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Presenting Author(s)

Jan Stasko, MD, PhD (he/him/his)

university professor
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Background: Antithrombin (AT) deficiency is a significant risk factor of venous thromboembolism (VTE). The annual incidence of VTE in AT-deficient family members is 1.24%, 95% confidence interval is 0.72-1.99%.

Aims: To present the case of the patient with AT deficiency and recurrent thromboembolic complications.

Methods: In this case report, we describe a 74-year-old patient with AT deficiency and negative family history of VTE.

Results: At first, the patient developed deep venous thrombosis (DVT) of the left leg in 2012. For the 2nd time, the patient observed the edema of the right leg worsened by the long flight by the plane (> 4 hours). However, 1 month before, he had bronchopneumonia. The ultrasonography detected DVT of the superficial femoral vein (SFV), popliteal vein (PV), posterior tibial vein (PTV) and veins of the foot. Moreover, computed tomography revealed bilateral pulmonary embolism in the pulmonary artery extending to its segmental branches. Therefore, he received low molecular weight heparin (LMWH) in the therapeutic dose and after 8 days of treatment, he started to use rivaroxaban 20 mg daily. After one year, he developed the recurrence of DVT in the right leg localized in the great saphenous vein, PV, PTV, fibular veins and anterior tibial veins.

His further clinical and laboratory findings and treatment are summarized in Table 1.

Conclusion(s): Assessment of changes in hemostasis in such patient with repeated development of VTE and AT deficiency requires individual approach. Currently, the patient is without further VTE complications.

The study complies with the Declaration of Helsinki and from the patient, the informed consent was obtained. The study was approved by a recognized medical Ethics Committee.
Acknowledgement: We would like to thank the support of projects of Scientific Grant Agency Vega 1/0168/16, Vega 1/0549/19 and Vega 1/0479/21.