Document Detail

Recurrent leg ulcers in a young man with hyperhomocysteinemia, factor V Leiden and impaired fibrinolysis.
MedLine Citation:
PMID:  12013200     Owner:  NLM     Status:  MEDLINE    
We present a young male patient referred to our hospital with leg ulcers on both legs that were more than 3 years refractory to standard treatment with compression therapy. By thrombophilia screening factor V Leiden mutation, hyperhomocysteinemia and evidence for impaired fibrinolysis were found. Treatment with folic acid in combination with long-term oral anticoagulant therapy was added to non-elastic compression therapy. The leg ulcers showed slow improvement and complete healing within 3 years. During a 6-year follow-up period neither new thrombo-embolic events occurred nor recurrence of ulcerations. This case suggests a potential synergistic pathogenic role of factor V Leiden, hyperhomocysteinemia and impaired fibrinolysis in the development of postthrombotic syndrome and his sequelae. We postulate that increased formation of thrombi in the microcirculation of the skin in combination with ambulatory venous hypertension due to recurrent deep venous thrombosis might explain our observation.
D N Kolbach; J C J M Veraart; K Hamulyák; L J M Spaapen; H A M Neumann
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta dermato-venereologica     Volume:  82     ISSN:  0001-5555     ISO Abbreviation:  Acta Derm. Venereol.     Publication Date:  2002  
Date Detail:
Created Date:  2002-05-15     Completed Date:  2002-11-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370310     Medline TA:  Acta Derm Venereol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  52-4     Citation Subset:  IM    
Department of Dermatology, University Hospital Maastricht, The Netherlands.
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MeSH Terms
Adrenal Cortex Hormones / administration & dosage
Chronic Disease
Combined Modality Therapy
Drug Therapy, Combination
Factor V / analysis,  genetics*
Fibrinolytic Agents / administration & dosage
Folic Acid / administration & dosage*
Follow-Up Studies
Hyperhomocysteinemia / complications,  diagnosis*,  genetics,  therapy
Leg Ulcer / complications,  diagnosis*,  genetics,  therapy
Phlebography / methods
Severity of Illness Index
Thrombophilia / complications,  diagnosis*,  therapy
Treatment Outcome
Venous Thrombosis / complications,  diagnosis*,  therapy
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Fibrinolytic Agents; 0/factor V Leiden; 59-30-3/Folic Acid; 9001-24-5/Factor V

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