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Revista Cubana de Hematología, Inmunología y Hemoterapia

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ISSN 0864-0289 (Print)
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2015, Number 4

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Rev Cubana Hematol Inmunol Hemoter 2015; 31 (4)

G20210a mutation of the prothrombin gene: clinical presentation in two pregnant women

Cabrera-Payne Y, Castillo-González D, Rodríguez-Pérez L, Tejeda-González M, Fonseca-Polanco C, Rubio BY
Full text How to cite this article

Language: Spanish
References: 18
Page: 459-465
PDF size: 82.55 Kb.


Key words:

G20210A mutation of the prothrombin gene, inherited thrombophilia, pregnancy.

ABSTRACT

Hereditary thrombophilia is a genetic disease that results from two or more mutations in genes involved in the hemostatic system, with variable penetrance of the thrombotic phenotype. Among the mutated genes associated with increased risk of venous thrombosis is mutation G20210A prothrombin gene. We present two pregnant young patients who attended the Haemostasis outpatient service at the Institute of Hematology and Immunology. One of them, with personal history of thromboembolic disease (TED) associated with use of oral contraceptives; and the other one, with a family history of TED and personal history of recurrent abortions. In both patients´ thrombophilia studies the G20210A mutation in the prothrombin gene in heterozygous state was detected. The patients received multidisciplinary medical monitoring and prophylactic treatment with low-dose aspirin until week 34 of gestation, and low molecular weight heparin during pregnancy and six weeks after delivery. Two births without obstetric or fetal complications were achieved. The gene expression of prothrombin G20210A is variable, even within the same family and may be influenced by acquired risk factors such as the use of oral contraceptives, pregnancy and the postpartum period.


REFERENCES

  1. Koenderman JS, Reitsma PH. Inherited Thrombophilia: Past, Present, and Future Research. In: Tranquilli A (ed). Thrombophilia. InTech;2011. DOI:10.5772/26050. Disponible en: http://www.intechopen.com/books/thrombophilia/inheritedthrombophilia- past-present-and-future-research (Citado Octubre 25, 2014).

  2. Poort SR, Rosendaal FR, Reitsma PH, Bertina RM. A common genetic variation in the 3'-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood. 1996 Nov;88(10):3698-703.

  3. Leitner J M, Mannhalter C, Jilma B. Genetic variations and their influence on risk and treatment of venous thrombosis. Pharmacogenomics. 2008 Apr;9(4):423-37. doi:10.2217/14622416.9.4.423.

  4. Bafunno V, Margaglione M. Genetic basis of thrombosis. Clin.Chem.Lab Med. 2010 Dec;48 (1):S41-S51. doi:10.1515/CCLM.2010.361.

  5. Emmerich J, Rosendaal FR, Cattaneo M, Margaglione M, De Stefano V, Cumming T, et al. Combined effect of factor V Leiden and prothrombin 20210A on the risk of venous thromboembolism--pooled analysis of 8 case-control studies including 2310 cases and 3204 controls. Study Group for Pooled-Analysis in Venous Thromboembolism. Thromb Haemost. 2001;86 (3);809-16.

  6. Robertson L, Wu O, Langhorne P, Twaddle S, Clark P, Lowe GD, et al; Thrombosis: Risk and Economic Assessment of Thrombophilia Screening (TREATS) Study. Thrombophilia in pregnancy: a systematic review. Br J Haematol. 2006 Jan;132(2):171-96.

  7. Silver RM, Zhao Y, Spong CY, Sibai B, Wendel G Jr, Wenstrom K, et al. Prothrombin gene G20210A mutation and obstetric complications. Obstet Gynecol. 2010 Jan;115(1):14-20. doi: 10.1097/AOG.0b013e3181c88918.

  8. Franco RF, Reitsma PH. Genetic risk factors of venous thrombosis. Hum.Genet. 2001 Oct;109 (4):369-84.

  9. Simone B, De Stefano V, Leoncini E, Zacho J, Martinelli I, Emmerich J, et al. Risk of venous thromboembolism associated with single and combined effects of Factor V Leiden, Prothrombin 20210A and Methylenetethraydrofolate reductase C677T: a meta-analysis involving over 11,000 cases and 21,000 controls. Eur J Epidemiol. 2013 Aug;28(8):621-47. doi:10.1007/s10654-013-9825-8.

  10. Martinelli I, Sacchi,E, Landi G, Taioli E, Duca F, Mannucci PM. High risk of cerebral vein thrombosis in carriers of a prothrombin gene mutation and in users of oral contraceptives. N Engl J Med. 1998 Jun;338(25):1793-7. doi:10.1056/NEJM199806183382502

  11. Girolami A, Scarano L, Tormene D, Cella G. Homozygous patients with the 20210 G to A prothrombin polymorphism remain often asymptomatic in spite of the presence of associated risk factors. Clin Appl Thromb Hemost. 2001 apr;7(2):122-5.

  12. Said JM, Higgins JR, Moses EK, Walker SP, Monagle PT, Brennecke SP. Inherited thrombophilias and adverse pregnancy outcomes: a case-control study in an Australian population. Acta Obstet Gynecol Scand. 2012 Feb;91(2):250-5. doi:10.1111/j.1600-0412.2011.01293.x.

  13. Kahn SR, Platt R, McNamara H, Rozen R, Chen MF, Genest J Jr, et al. Inherited thrombophilia and preeclampsia within a multicenter cohort: the Montreal Preeclampsia Study. Am J Obstet Gynecol. 2009 Feb;200(2):151.e1–9. doi: 10.1016/j.ajog.2008.09.02

  14. Grandone E, Margaglione M, Colaizzo D, D'Andrea G, Cappucci G, Brancaccio V, et al. Genetic susceptibility to pregnancy-related venous thromboembolism: roles of factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T mutations. Am J Obstet Gynecol. 1998 Nov;179(5):1324-8.

  15. Ocak Z, Özlü T, Ozyurt O. Association of recurrent pregnancy loss with chromosomal abnormalities and hereditary thrombophilias. Afr Health Sci. 2013 Jun;13(2):447-52. doi:10.4314/ahs.v13i2.35.

  16. Ozdemir O, Yenicesu GI, Silan F, Köksal B, Atik S, Ozen F, et al. Recurrent pregnancy loss and its relation to combined parental thrombophilic gene mutations. Genet Test Mol Biomarkers. 2012 Apr;16(4):279-86. doi:10.1089/gtmb.2011.0191.

  17. García D, Paoletti M, Paoletti E, Ferreras R, Suárez-González L, Soto J, et al. Factores trombofÍlicos en mujeres abortadoras y con trombosis venosa profunda en el puerperio. Rev Hematol Mex. 2014 ene-mar;15(1):3-10.

  18. Bates S, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence- Based Clinical Practice Guidelines. Chest. Feb 2012;141(2 Suppl):e691S–e736S.




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Rev Cubana Hematol Inmunol Hemoter . 2015;31