• Internal medicine · Mar 2023

    Review

    Three Cases of Unprovoked Venous Thromboembolism with Prothrombin p.Arg596Gln Variant and a Literature Review of Antithrombin Resistance.

    • Akihiro Tsuji, Toshiyuki Miyata, Akihiro Sekine, Reiko Neki, Koichi Kokame, Tsutomu Tomita, Yumi Kashima, Ryotaro Asano, Jin Ueda, Tatsuo Aoki, and Takeshi Ogo.
    • Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan.
    • Intern. Med. 2023 Mar 15; 62 (6): 885888885-888.

    AbstractAntithrombin resistance (ATR) is a newly identified strong genetic predisposition to venous thromboembolism (VTE) caused by genetic variations in prothrombin with substitutions of Arg at position 596 with either Leu, Gln, or Trp. In the present report, we identified a missense variant p.Arg596Gln in 3 patients from 2 families with unprovoked VTE who each experienced their first VTE event at 19, 67, and 19 years old. The three patients did not show any positive markers for thrombophilia on routine testing, suggesting that patients with unprovoked VTE who have negative findings on thrombophilia tests may carry a prothrombin variant with ATR.

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