ISSN 2997-1036
International Journal of Hematology | Vol. 3, No. 3, March 2012 | pp. 17–24
DOI: 10.46882/2012/IJH/000027
Case Report
Title: Deep vein thrombosis associated with congenital antithrombin III deficiency in a young pregnant female
Names of Authors: K. L. Musa¹, M. N. Lawal², O. P. Dikko³
Authors’ Affiliations: ¹Department of Haematology, Federal Medical Centre, Katsina, Nigeria; ²Department of Obstetrics and Gynaecology, Bayero University, Kano, Nigeria; ³Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
Abstract: Pregnancy induces a physiological hypercoagulable state that increases the risk of thromboembolic events in women with underlying inherited thrombophilias. We report a 23-year-old primigravida at 14 weeks of gestation who presented with painful, progressive swelling of the left lower limb lasting 4 days. Doppler ultrasonography confirmed an extensive deep vein thrombosis involving the left common femoral and popliteal veins. Functional coagulation assays revealed a severe reduction in antithrombin III activity (42.0%), while protein C, protein S, and lupus anticoagulant screens were normal. Family history revealed recurrent thromboembolism in her maternal uncle. Anticoagulant therapy was initiated with therapeutic low-molecular-weight heparin (enoxaparin, 1 mg/kg subcutaneously every 12 hours), achieving complete resolution of symptoms and preserving fetal viability. Enoxaparin was adjusted based on anti-Factor Xa levels and continued throughout pregnancy, followed by a transition to oral warfarin postpartum. This case demonstrates the importance of considering congenital anticoagulant deficiencies in young pregnant patients presenting with unprovoked venous thrombosis.
Keywords: Antithrombin III deficiency, pregnancy, deep vein thrombosis, low-molecular-weight heparin, thrombophilia
Manuscript Timeline: Received: December 01, 2011; Revised: January 12, 2012; Accepted: February 02, 2012; Published: March 16, 2012