A case of congenital antithrombin III deficiency complicated by giant thrombus of postcava.

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We succeeded in an anticoagulant therapy of a postcaval giant thrombus in a 14 year old male with a heterozygous AT III deficiency. The diagnosis of AT III deficiency was confirmed by laboratory findings of him and his family members on the neneth hospital week (Table 1, 2, Fig. 1). He was initially treated with gabexate mesilate, and then with AT III concentrate and warfarin. These treatments brought remarkable improvement of his clinical status and labolatory findings (Fig. 2). Four months after initiation of the treatment with AT III concentrate and warfarin, the thrombus of postcava disappeared. These results suggested that therapy with AT III concentrate and warfarin was effective not only in acute phase but in subacute phase of thrombosis in AT III deficiency.Furthermore we examined FDP-E, FDP-D dimer, TAT complex and plasmin-α2PI complex in nine relatives with heterozygous AT III deficiency who had not experienced thrombotic problems (Table 3). Abnormal values were observed in eight of nine on TAT complex, seven of nine on Plm-α2PI complex, four of nine on FDP-E, and two of nine on FDP-D dimer. These data revealed latent hypercoagulable states in some of these patients. And consequently, analysis of these markers might be useful to detect the risk of thrombosis in AT III deficiency.
一般社団法人日本血栓止血学会の論文