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1 May 1992

Thrombosis in Antithrombin-III-deficient Persons: Report of a Large Kindred and Literature Review

Publication: Annals of Internal Medicine
Volume 116, Number 9

Abstract

Purpose: To estimate the prevalence of objectively proven thrombotic complications in antithrombin-III-deficient persons.
Study Design: Cross-sectional study and a critical review of the literature.
Data Sources and Extraction: The prevalence of thrombosis in antithrombin III-deficient and -nondeficient family members of a large kindred was estimated by history, review of diagnostic tests, and examination for venous reflux by Doppler ultrasonography, as an indicator of previous venous thrombosis.
A MEDLINE search and literature review of the published English- and French-language literature from 1966 to 1990 that described antithrombin-III-deficient families was done, and the following information was obtained: the prevalence of thrombosis in deficient and nondeficient family members, the presence or absence of risk factors for thrombosis (surgery, pregnancy, the postpartum state, use of oral contraceptives, immobiization, metastatic cancer, major trauma) at the time of the thrombotic event, and age of onset of the first episode of thrombosis. The validity of the studies was assessed according to predetermined criteria.
Results: Sixty-seven research subjects were evaluated. Six of 31 (19.4%) antithrombin-III-deficient subjects compared with none of 36 (0%) nondeficient subjects had had one or more thrombotic events. The initial episode in five of six subjects had occurred in association with risk factors for thrombosis.
The literature search indicated that the pooled prevalence of symptomatic venous thrombosis among the deficient subjects was 51%, but objective testing was done in only 17% of these subjects at the time of presentation.
Conclusion: Based on the data from this antithrombin-III-deficient kindred, lifelong anticoagulant prophylaxis does not appear to be warranted in asymptomatic carriers, and prophylaxis could be limited to periods of high risk for thrombosis.

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cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 116Number 91 May 1992
Pages: 754 - 761

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Published in issue: 1 May 1992
Published online: 1 December 2008

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Jeffrey S. Ginsberg, MD
Morris A. Blajchman, MD
From McMaster University and the Canadian Red Cross Society, Hamilton, Ontario, Canada. For current author addresses, see end of text.

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Christine Demers, Jeffrey S. Ginsberg, Jack Hirsh, et al. Thrombosis in Antithrombin-III-deficient Persons: Report of a Large Kindred and Literature Review. Ann Intern Med.1992;116:754-761. doi:10.7326/0003-4819-116-9-754

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