Summary
The prevalence of coagulation disorders in patients with upper extremity deep-vein
thrombosis (UE-DVT) is unknown due to only a few observational studies of limited
size reporting varying results. Therefore, we aimed to evaluate the prevalence of
thrombophilia in patients with UE-DVT compared to patients with lower extremity deep
vein thrombosis (LE-DVT). One hundred fifty consecutive patients (15 to 91 years of
age) with UE-DVT were recruited from the MAISTHRO (MAin-ISar-THROmbosis) registry.
Three hundred LE-DVT patients matched for gender and age served as controls. Thrombophilia
screening included tests for the factor V Leiden mutation, the prothrombin G20210A
mutation, antiphospholipid antibodies and factor VIII (FVIII), protein C, protein
S and antithrombin activities. At least one thrombophilia was present in 34.2% of
UE-DVT and 39.2% in UE-DVT that was unrelated to venous catheters relative to 55.3%
in LE-DVT patients (p<0.001). In particular, a persistently elevated FVIII is less
likely to be found in UE-DVT patients than in those with LE-DVT and is the only thrombophilia
that is differentially expressed after controlling for established VTE risk factors
[OR 0.46, (95% CI 0.25–0.83)]. Although less prevalent than in LE-DVT patients, thrombophilia
is a common finding in patients with UE-DVT, especially in those with thrombosis that
is unrelated to venous catheters.
Keywords
Upper extremity DVT - thrombophilia - factor VIII - venous catheters - malignancy