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Ung kvinna med p-ring drabbad av armtrombos: möjligt samband med mutation i protrombingenen
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
medicinkliniken och Brunflo Hälsocentral, Jämtlands läns landsting.
Läkemedelsverket, Uppsala.
2007 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, no 1-2, 32-34 p.Article in journal (Other academic) Published
Abstract [sv]

En ung kvinna fick en trombosi vena axillaris under p-ringanvändning. Trombosutredningpåvisade heterozygoti för 20210G>A i protrombingenen, en mutation som kan ha särskildbetydelse vid armtrombos.

Incidensen av trombos under p-pilleranvändning beräknas till 2–4 fall per 10 000 användarår. Inget talar för att kombinerad hormonell antikonceptioni form av vaginal ring eller plåster innebär lägre risk förblodpropp. P-ringen marknadsförs med budskap om låga hormon nivåer, men betydelsen av detta är oklar, då den totala östrogeniteten är hög.

Fyra fall av blodpropp under NuvaRing-användning i Sverigehar hittills rapporterats till biverkningsenheten. Ur rapporterna framgår det att pringen inte alltid uppfattas som ett systemiskt verkande hormonellt antikonceptions medel.

Abstract [en]

We report a case of axillary vein thrombosis in a young woman. The only identified risk factors included heterozygosity for the prothrombin 20210A variant, heavy lifting, and use of NuvaRing, a novel form of combined hormonal contraception. Thrombosis of the upper extremity veins is a rare condition that is often associated with specific local risk factors such as the presence of a central venous catheter, strenuous muscular effort or upper limb trauma. Recent research has also shown an association to traditional risk factors for venous thromboembolism (VTE) including coagulation abnormalities, surgery, immobilization, use of hormonal contraception and a family history of VTE. It is important to be aware of the rare occurrence of VTE associated with combined hormonal contraception. There is no evidence that vaginal administration is associated with a lower risk of VTE. Four cases of VTE with NuvaRing have hitherto been reported to the Swedish Medical Products Agency accounting for a reported incidence of 5,3 (95% CI 1,4-13,5) cases per 10 000 women years of use.

Place, publisher, year, edition, pages
Stockholm: Sveriges läkarförbund , 2007. Vol. 104, no 1-2, 32-34 p.
Keyword [en]
Administration; Intravaginal, Adult, Axillary Vein, Contraceptive Agents; Female/administration & dosage/*adverse effects, Contraceptives; Oral; Combined/administration & dosage/*adverse effects, Desogestrel/administration & dosage/adverse effects, Ethinyl Estradiol/administration & dosage/adverse effects, Female, Heterozygote, Humans, Mutation, Prothrombin/*genetics, Risk Factors, Venous Thrombosis/chemically induced/*etiology/genetics
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:umu:diva-5836PubMedID: 17323737OAI: oai:DiVA.org:umu-5836DiVA: diva2:145504
Note

English title: Axillary vein thrombosis in a young woman with a contraceptive ring. Prothrombin gene mutation a possible connection

Available from: 2007-11-30 Created: 2007-11-30 Last updated: 2017-12-14Bibliographically approved

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