Deep vein thrombosis case study

Douketis JD, Julian JA, Kearon C, Anderson DR, Crowther MA, Bates SM, Barone M, Piovella F, Turpie AG, Middeldorp S, van Nguyen P, Prandoni P, Wells PS, Kovacs MJ, Macgillavry MR, Costantini L, Ginsberg JS. Does the type of hormone replacement therapy influence the risk of deep vein thrombosis A prospective case-control study. J Thromb Haemost 2005 3(5) 943-8. 

Data from the Leiden Thrombophilia Study have been used to construct a case-control study, based on contraceptive users who had experienced a first episode of objectively proven deep vein thrombosis (100). Patients and controls were considered thrombophilic when they had protein C deficiency, protein S deficiency, antithrombin deficiency, factor V Leiden mutation, or a prothrombin 20210 A mutation. Among healthy women, the risk of developing deep vein thrombosis was trebled in the first 6 months and doubled in the first year of contraceptive use. Among women with thrombophilia, the risk of deep vein thrombosis was increased 19-fold during the first 6 months and 11-fold (95% Cl = 2.1, 57) in the first year of use. Venous thrombosis during the first period of oral contraceptive use might actually point to the presence of an inherited clotting defect. 

Heit JA, Sdverstein MD, Mohr DN, Petterson TM, O Fallon WM, Melton LJ. Risk factors for deep vein thrombosis and pulmonary embolism a population-based case-control study. Arch Intern Med 2000 160 809-15. 

Baccarelli et al. (2008) studied in a case-control study 870 patients with deep vein thrombosis (DVT) and 1210 healthy controls from the Lombardy region in Italy, who were examined between 1995 and 2005. They estimated exposure to PMio in the year before DVT diagnosis (cases) or examination (controls) through area-specific mean levels obtained from ambient monitors. Each increase of 10 pg/ m in PMio was associated with a 70% increase in DVT risk (OR 1.70 95% Cl 1.30-2.23). 

Observational studies In a multicenter case series, 25 women received recombinant Factor Vila for treatment of severe obstetric haemorrhage [123 ]. A total of 9 patients experienced 11 adverse events within 28days of rFVIIa exanthema (n= 1), fever (n=1), hypopituitarism (n= 1), acute myocardial infarction (n=1), ileus (n = 1), asymptomatic deep vein thrombosis (n=2), asymptomatic PE (n=2) and allergic reaction (n=2). 

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