Système gastro-intestinal et digestif

Abstrait

Thrombophilia Evaluation during Acute Mesenteric Ischaemia

Raghavendra N

Background: Unlike studies on vascular thromboses in the limbs, there have been few studies in Acute mesenteric ischaemia (AMI) evaluating thrombophilia. We have attempted to analyze the usefulness of evaluation for heritable thrombophilia in AMI.

Methods: We retrospectively studied 29 patients with AMI. All patients underwent haematological tests to detect a deficiency of natural anticoagulant proteins. Sixteen of these patients underwent genetic studies for common genetic mutations accounting for heritable thrombophilia and other blood tests for the presence of procoagulant factors.

Results: Fifteen patients had mesenteric venous thrombosis (MVT) and 14 had mesenteric arterial occlusion (MAO). Of the 16 patients undergoing genetic studies, 7 (44%) were found to have MTHFR C677T polymorphism, none were found to have FVL and PT gene mutations. Protein C, S and AT III levels were decreased in most of the patients. The median levels of these were higher in patients with MVT than in those with MAO.

Conclusions: The MTHFR C677T polymorphism appears to be the most common genetic defect associated with AMI in India. Protein C, S and AT III levels measured during the acute thrombotic episode may not represent their actual levels to detect a deficiency.