• Sao Paulo Med J · Sep 2002

    Case Reports

    Methylene tetrahydrofolate reductase gene mutation together with anticardiolipin antibody during pregnancy: a case report.

    • Egle Couto, Ricardo Barini, Marcelo Luís Nomura, and Joyce Maria Annichino-Bizzacchi.
    • Departamento de Ginecologia e Obstetrícia, Universidade Estadual de Campinas, São Paulo, Brazil. egle@unicamp.br
    • Sao Paulo Med J. 2002 Sep 2; 120 (5): 152153152-3.

    ContextHigh plasmatic homocysteine levels have been associated with arterial and venous thrombosis. The C677T methylene tetrahydrofolate reductase (MTHFR) gene mutation is one of the known causes for high homocysteine levels in plasma. Anticardiolipin antibody (ACA) is also associated with thrombosis and, along with other clinical complications such as recurrent abortion and stillbirth, is part of the antiphospholipid syndrome.DesignCase report.Case ReportA 19-year-old woman with two gestations and one parity (G2P1) had exhibited deep venous thrombosis in her previous puerperal period. Investigation of thrombophilic factors revealed ACA-IgM and heterozygous C677T mutation in the MTHFR gene. Lupus anticoagulant, protein C, protein S and antithrombin III deficiencies, and Leiden factor V and the G20210A mutation in the prothrombin gene, were not detected. The patient received 55,000 IU of subcutaneous heparin daily, from the 15th to the 36th week of pregnancy, when vaginal delivery took place. There were no clinical complications during the puerperal period and she was discharged three days after delivery, while still using oral anticoagulants.

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