Subscribe to RSS
DOI: 10.1055/s-0038-1656022
Clinical Features in 36 Patients Homozygous for the ARG 506 → GLN Factor V Mutation
Publication History
Received 08 August 1996
Accepted after revision 09 December 1996
Publication Date:
26 July 2018 (online)
Summary
We analyzed the clinical features of 36 patients homozygous for the Arg 506 to Gin factor V mutation and found a circumstantial event at risk for thrombosis in 29 of the 31 patients with thrombosis. The most frequent predisposing factors were the post-partum period and the use of oral contraceptives in women, and surgery in both sexes. Venous thrombosis recurred in 48% of the patients. One patient had a myocardial infarction at age 33 years, and also had an antiphospholipid syndrome. Homozygous Gin 506 mutation leads to far less severe thrombotic complications than homozygous protein C and protein S deficiencies and does not seem to predispose patients to arterial thrombosis.
-
References
- 1 Dahlbäck B, Carlsson M, Svensson P. Familial thrombophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein C: prediction of a cofactor to activated protein C. Proc Natl Acad Sci USA 1993; 90: 1004-1008
- 2 Dahlbäck B. Resistance to activated protein C, the Arg 506 to Gin mutation in the factor V gene and venous thrombosis. Funcional tests and DNAbased assays, pros and cons Thromb Haemost 1995; 73: 739-742
- 3 Bertina RM, Reitsma PH, Rosendaal FR, Vandenbrouke JP. Resistance to activated protein C and factor V Leiden as risk factors for venous thrombosis. Thromb Haemost 1995; 74: 449-453
- 4 Rees DC, Cox M, Clegg JB. World distribution of factor V Leiden. Lancet 1995; 346: 1133-1134
- 5 Kalafatis M, Bertina RM, Rand MD, Mann KG. Characterization of the molecular defect in factor V R506Q. J Biol Chem 1995; 270: 4053-4057
- 6 Heeb MJ, Kojima Y, Greengard JS, Griffin JH. Activated protein C resistance: Molecular mechanisms based on studies using purified Gin 506 factor V. Blood 1995; 85: 3405-3411
- 7 Zöller B, Svensson PJ, He X, Dahlbäck B. Identification of the same factor V gene mutation in 47 out of 50 thrombosis'prone families with inherited resistance to activated protein C. J Clin Invest 1994; 94: 2521-2524
- 8 Rosendaal FR, Koster T, Vandenbroucke JP, Reitsma PH. High risk of thrombosis in patients homozygous for factor V Leiden (activated protein C resistance). Blood 1995; 85: 1504-1508
- 9 Seligsohn U, Berger A, Abend M, Rubin L, Attias D, Zivelin RapaportSI. Homozygous protein C deficiency manifested by massive venous thrombosis in the newborn. N Engl J Med 1984; 310: 559-562
- 10 Mahasandana C, Suvatte V, Marlar RA, Johnson MJ, Jacobson LJ, Hathaway WE. Neonatal purpura fulminans associated with homozygous protein S deficiency. Lancet 1990; 335: 61-62
- 11 Ridker PM, Hennekens CH, Lindpaintner K, Stampfer MJ, Eisenberg PR, Miletich JP. Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction stroke and venous thrombosis in apparently healthy men. N Engl J Med 1995; 332: 912-917
- 12 Emmerich J, Poirier O, Evans A, Marques-Vidal P, Arveiler D, Luc G, Aiach M, Cambien F. Myocardial infarction, Arg 506 to Gin factor V mutation, and activated protein C resistance. Lancet 1995; 35: 321
- 13 Emmerich J, Aiach M. Myocardial infarction and Arg 506 to Gin mutation. N Engl J Med 1995; 333: 880-881
- 14 Holm J, Zöller B, Svensson PJ, Bemtorp E, Erhardt L, Dahlbäck B. Myocardial infarction associated with homozygous resistance to activated protein C. Lancet 1994; 344: 952-953
- 15 Hopmeier P, Krugluger W. Factor V Leiden and thrombophilia. N Engl J Med 1994; 332: 1381-1382
- 16 Miller S, Dykes D, Polesky H. A simple salting out procedure for extracting DNA from human nucleated cells. Nucl Acid Res 1988; 16: 1215
- 17 Gandrille S, Alhenc-Gelas M, Aiach M. A rapid screening method for the factor V Arg 506 to Gin mutation. Blood Coag Fibrinol 1995; 06: 245-249
- 18 Greengard JS, Eichinger S, Griffin JH, Bauer KA. Variability of thrombosis among homozygous siblings with resistance to activated protein C due to an Arg →x Gin mutation in the gene for factor V. N Engl J Med 1994; 331: 1559-1562
- 19 Simioni P, Scudeller A, Girolami A. Factor V Leiden and thrombophilia. N Engl J Med 1994; 332: 1382
- 20 Zöller B, He X, Dahlbäck B. Homozygous APC resistance combined with inherited protein S deficiency in a young boy with severe thrombotic disease. Thromb Haemost 1995; 73: 743-745
- 21 Villa P, Aznar J, Jorquera J, Mira Y, Vaya A, Fernandez MA. Inherited homozygous resistance to activated protein C. Thromb Haemost 1995; 74: 794-795
- 22 Samama M, Trossaért M, Horellou MH, Elalamy I, Conard J, Deschamps A. Risk of thrombosis in patients homozygous for factor V Leiden. Blood 1995; 86: 4700-4701
- 23 Rintelen C, Mannhalter C, Ireland H, Lane DA, Knöbl P, Lechner K, Pabinger I. Oral contraceptives enhance the risk of clinical manifestation of venous thrombosis at a young age in females homozygous for factor V Leiden. Br J Haematol 1996; 93: 487-490
- 24 Zöller B, Bemtsdotter A, Garcia deFrutos P, Dahlbäck B. Resistance to activated protein C as an additional genetic risk factor in hereditary deficiency of protein S. Blood 1995; 12: 3518-3523
- 25 Koeleman BPC, Reitsma PH, Allaart CF, Bertina RM. Activated protein C resistance as an additional risk factor for thrombosis in protein C deficient families. Blood 1994; 84: 1031-1035
- 26 Vandenbroucke JP, Koster T, Briët E, Bertina PH, Rosendaal FR. Increased risk of venous thrombosis in oral contraceptive userswho are carriers of factor V Leiden mutation. Lancet 1994; 344: 1453-1456
- 27 De StefanoV, Mastrangelo S, Paciaroni K, Ireland H, Lane DA, Scirpa P, Bizzi B, Leone G. Thrombotic risk during pregnancy and puerperium in women with APC resistance. Effective subcutaneous heparin prophylaxis in a pregnant patient. Thromb Haemost 1995; 74: 793-794
- 28 Schulman S, Rhedin A-S, Lindmarker P, Carlsson A, Läfars G, Nicol P. et al. A comparison of six weeks with six months of oral anticoagulants therapy after a first episode of venous thromboembolism. N Engl J Med 1995; 332: 1661-1665
- 29 Ridker PM, Miletich JP, Stampfer MJ, Goldhaber SZ, Lindpaintner K, Hennekens CH. Factor V Leiden and risks of recurrent idiopathic venous thromboembolism. Circulation 1995; 92: 2800-2802
- 30 März W, Seyedewitz H, Winkelmann B, Chen M, Nauck M, Witt I. Mutation in coagulation factor V associated with resistance to activated protein C in patients with coronary artery disease. Lancet 1995; 345: 526-527
- 31 Van BockxmeeerFM, Baker RI, Taylor RR. Premature ischaemic heart disease and the gene for coagulation factor V. Nature Medicine 1995; 01: 185
- 32 Kontula K, Ylikorkala A, Miettinen H, Vuorio A, Kauppinen-Makelin R, Hämäläinen L, Palomäki H, Kaste M. Arg 506 Gin factor V mutation (factor V Leiden) in patients with ischaemic cerebrovascular disease and survivors of myocardial infarction. Thromb Haemost 1995; 73: 558-560
- 33 Samani NJ, Lodwick D, Martin D, Kimber P. Resistance to activated protein C and risk of premature myocardial infarction. Lancet 1994; 344: 1709-1710
- 34 Cushman M, Bhushan F, Bovill E, Tracy R. Plasma resistance to activated protein C in venous and arterial thrombosis. Thromb Haemost 1994; 72: 647
- 35 Demarmels BiassiuttiF, Merlo C, Sulzer I, Binder BR, Lämmle B. No association of APC resistance with myocardial infarction. Blood Coagul Fibrinol 1995; 06: 456-459
- 36 Ardissino D, Peyvandi F, Merlini PA, Colombi E, Mannucci PM. Factor V (Arg 506 → Gin) mutation in young survivors of myocardial infarction. Thromb Haemost 1996; 75: 701-702