Hamostaseologie 2009; 29(S 01): S84-S86
DOI: 10.1055/s-0037-1621494
Original article
Schattauer GmbH

Malignant stroke in an adolescent with a homozygous MTHFR 677CT mutation and intake of hormonal contraceptives

K. Pfurtscheller
1   Department of Paediatrics and Adolescence Medicine Medical University of Graz, Austria
,
B. Senning
1   Department of Paediatrics and Adolescence Medicine Medical University of Graz, Austria
,
H. Bernhard
1   Department of Paediatrics and Adolescence Medicine Medical University of Graz, Austria
,
M. Novak
1   Department of Paediatrics and Adolescence Medicine Medical University of Graz, Austria
,
G. Zobel
1   Department of Paediatrics and Adolescence Medicine Medical University of Graz, Austria
,
B. Plecko
1   Department of Paediatrics and Adolescence Medicine Medical University of Graz, Austria
,
W. Muntean
1   Department of Paediatrics and Adolescence Medicine Medical University of Graz, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
04 January 2018 (online)

Summary

Severe stroke in children and adolescents with its devastating long term consequences remains a rare disorder with many open questions. Beside the well known risk factors such as infection or congenital and acquired heart disease, coagulation disorders have to be considered in the differential work up of the underlying aetiology. Here we report the case of an adolescent with a homozygote MTHFR 677CT mutation suffering a malignant stroke shortly after the start of oral contraceptives. Conclusion: Since prevention seems easily feasible, general screening for MTHFR mutations might be worthwhile in women before starting oral contraceptives.

 
  • References

  • 1 Arias E, Anderson R, Kung H. Deaths: final data for 2001. Natl Vital Stat Rep 2003; 52: 1-115.
  • 2 Lynch J, Hirtz D, de Veber J. Report of the National Institute of Neurological Disorders and Stroke Workshop on perinatal and childhood stroke. Pediatrics 2002; 109: 116-123.
  • 3 De Veber J. In pursuit of evidence-based treatments for pediatric stroke: the UK and Chest guidelines. Lancet Neurol 2005; 4: 432-436.
  • 4 Agnetti A, Carano N, Sani E. Cryptogenic stroke in children: possible role of patent Foramen ovale. Neuropediatrics 2007; 6: 53-56.
  • 5 Nowak-Göttl U, Sträter R, Heinecke A. et al. Lipoprotein (a) and genetic polymorphisms of clotting factor V, prothrombin, and methylenetetrahydrofolate reductase are risk factors of spontaneous ischemic stroke in childhood. Blood 1999; 94: 3678-3682.
  • 6 Kenet G, Sadetzki S, Murad H. et al. Factor V Leiden and antiphospholipid antibodies are significant risk factors for ischemic stroke in children. Stroke 2000; 31: 1283-1288.
  • 7 Kirkham F, Sébire G, Steinlin M, Sträter R. Arterial ischaemic stroke in children. J Thromb Haemost 2004; 92: 697-706.
  • 8 D’Angelo A, Selhub J. Homocystein and thrombotic disease. Blood 1997; 90: 1-11.
  • 9 Pezzini A, Grassi M, Del Zotto E. et al. Interaction of homocystein and conventional predisposing factors on risk of ischaemic stroke in young people: consistency in phenotype – disease analysis and genotype-disease analysis. J Neurol Neurosurg Psychiat 2006; 77: 1150-1156.
  • 10 Slooter AJ, Rosendaal FR, Tanis BC. et al. Prothrombotic conditions, oral contraceptives, and the risk of ischemic stroke. J Thromb Haemost 2005; 3: 1213-1217.