Oxymetholone Therapy in Patients with Familial Antithrombin III Deficiency

Summary

Three patients with familial antithrombin III (ATIII) deficiency, who also have histories of thromboembolism, were treated with oxymetholone in combination with warfarin. Thrombolysis was observed in one patient with acute thrombosis of inferior vena cava during the oxymetholone and warfarin therapy. No further thromboembolic episodes occurred in these patients after initiation of warfarin with or without oxymetholone. The levels of plasma ATIII, α₁-antitrypsin, plasminogen and Cl-inactivator were significantly increased in all patients after the introduction of oxymetholone therapy. This suggests that oxymetholone augments anticoagulant and fibrinolytic activity. Hence we consider that oxymetholone in combination with warfarin may be possible thrombolytic therapy in patients with familial ATIII deficiency.

Keywords

Familial antithrombin III deficiency - Thromboembolism - Thrombolysis - Oxymetholone - warfarin

• References

• 1 Egeberg O. Inherited antithrombin deficiency causing thrombophilia. Thromb Diath Haemorrh 1965; 13: 516-530
• 2 Marciniak E, Farley CH, DeSimone PA. Familial thrombosis due to antithrombin III deficiency. Blood 1974; 43: 219-231
• 3 Barbosa J, Seal US, Doe RP. Effects of anabolic steroids on haptoglobin, orosomucoid, plasminogen, fibrinogen, transferrin, ceruloplasmin, α₁-antitrypsin, β-gluculonidase and total serum proteins. J Clin Endocr 1971; 33: 388-398
• 4 Davidson JF, Lochhead M, McDonald GA, McNicol GP. Fibrinolytic enhancement by stanozolol: A double blind trial. Br J Haematol 1972; 22: 543-559
• 5 Preston FE, Burakowski BK, Porter NR, Malia RG. The fibrinolytic response to stanozolol in normal subjects. Thromb Res 1981; 22: 543-551
• 6 Fiessinger JN, Aiach M. Stanozolol treatment in an AT III deficient patient. Thromb Haemostas 1980; 43: 183
• 7 Winter JH, Fenech A, Bennett B, Douglas AS. Prophylactic antithrombotic therapy with stanozolol in patients with familial antithrombin III deficiency. Br J Haematol 1984; 57: 527-537
• 8 Miller N, Hultin MB, Gounder M, Zarrabi MH. Hereditary antithrombin III deficiency: Case report and review of recent therapeutic advances. Am J Hematol 1986; 21: 215-221
• 9 Abildgaard U, Gravem K, Godal HC. Assay of progressive antithrombin in plasma. Thromb Diath Haemorrh 1970; 24: 224-229
• 10 Abildgaard U, Lie M, Odegard OR. Antithrombin (heparin cofactor) assay with “new” chromogenic substrates (S-2238 and Chromozym TH). Thromb Res 1977; 11: 549-553
• 11 Friberger P, Knös M, Gustavsson S, Aurell L, Claeson G. Methods for determination of plasmin, antiplasmin and plasminogen by means of substrate S-2251. Haemostasis 1978; 7: 138-145
• 12 Walker ID, Davidson JF, Young P, Conkie JA. Effect of anabolic steroids on plasma antithrombin III, α₂-macroglobulin and α₁-anti-trypsin levels. Thromb Diath Haemorrh 1975; 34: 106-114
• 13 Laurell CB, Rannevik G. A comparison of plasma protein changes induced by danazol, pregnancy, and estrogens. J Clin Endocrinol Metab 1979; 49: 719-725