Thromb Haemost 1994; 71(04): 416-419
DOI: 10.1055/s-0038-1642452
Review Article
Schattauer GmbH Stuttgart

High Incidence of Thrombophilia Detected in Chinese Patients with Venous Thrombosis

H W Liu
The Department of Pathology and Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
,
Y L Kwong
The Department of Pathology and Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
,
C Bourke
The Department of Pathology and Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
,
C K Lam
The Department of Pathology and Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
,
A K W Lie
The Department of Pathology and Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
,
D Wei
The Department of Pathology and Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
,
L C Chan
The Department of Pathology and Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
› Author Affiliations
Further Information

Publication History

Received: 29 December 1992

Accepted after resubmission: 13 December 1993

Publication Date:
06 July 2018 (online)

Summary

Venous thromboembolism is rare in Chinese. To determine the incidence and disease profile of thrombophilia in Chinese patients with thrombosis, 52 unselected Chinese patients with documented venous thrombosis were studied for the presence of thrombophilia. Levels of antithrombin III (AT III), protein C (PC) and protein S (PS) as well as the presence of acquired lupus anticoagulant (LA) and anticardiolipin antibody (ACA) were investigated. Thirty patients were found to be abnormal. These consisted of 5 AT III deficiencies, 9 PC deficiencies, 10 PS deficiencies, 1 combined PC & PS deficiency (all in the heterozygous range), and 5 patients with LA and/or ACA. When the patients with LA and/or ACA are excluded, the incidence of hereditary thrombophilia is 25/47 i.e. 53.2%' which is much higher than those reported in studies of Caucasian patients selected under strict criteria. Family studies performed in 16 cases ot hereditary thrombophilia revealed involvement in 11 cases (68.7%); a total of 36 heterozygous family members were affected, most of which remain asymptomatic. Although 35 events predisposing to thrombosis (27 pregnancies, 1 oral contraceptive consumption and 7 surgical operations) were identified among these index patients, and the heterozygous family members, thrombosis was observed on only 6 occasions (17.1%). The data suggest that pregnancy and surgery do not carry the same degree of thrombotic risk in Chinese as in the Caucasian population with heterozygous AT III, PC and PS deficiency.

 
  • References

  • 1 Hume M, Sevitt S, Thomas DP. Venous thrombosis and pulmonary embolism. Harvard University Press; Cambridge, MA : 1970. pp 136-7
  • 2 Hirsh J, Genton E, Hull R. Venous thromboembolism. Grune and Stratton; New York : 1981
  • 3 Kieregaard A. Incidence of acute deep vein thrombosis in two districts: a phlebographic study. Acta Chir Scand 1980; 146: 267-9
  • 4 Nandi P, Wong KP, Wei WI, Ngan H. Ong GB. Incidence of postoperative deep thrombosis in Hong Kong Chinese. Br J Surg 1980; 67: 251-3
  • 5 Tso SC, Wong V, Chan V, Chan TK, Ma HK, Todd D. Deep vein thrombosis and changes in coagulation and fibrinolysis after gynaecological operations in Chinese: the effect of oral contraceptives and malignant disease. Br J Haematol 1980; 46: 603-12
  • 6 Cheng KK, Lai ST, Yu TJ, Kuo SM. Postoperative deep vein thrombosis in the Taiwanese Chinese population. Am J Surg 1987; 153: 302-5
  • 7 Vikydal R, Korninger C, Kyrle PA, Niessner H, Pabinger I, Thaler E, Lechner K. The prevalence of hereditary antithrombin-III deficiency in patients with a history of venous thromboembolism. Thromb Haemost 1985; 54: 744-5
  • 8 Gladson CL, Scharrer I, Hach V, Beck KH, Griffin JH. The frequency of type 1 heterozygous protein S and protein C deficiency in 141 unrelated young patients with venous thrombosis. Thromb Haemost 1988; 59: 18-22
  • 9 Heijboer H, Brandjes DPM, Buller HR, Sturk A, Cate JWT. Deficiencies of coagulation-inhibiting and fibrinolytic proteins in outpatients with deep-vein thrombosis. N Engl J Med 1990; 323: 1512-6
  • 10 Tobelem G, Cariou R, Camez A. Lupus anticoagulant and its role in thrombosis. Blood Rev 1987; 1: 21-4
  • 11 Lechner K, Pabinger-Fashing I. Lupus anticoagulant and thrombosis. A study of 25 cases and review of the literature. Haemostasis 1985; 15: 254-62
  • 12 Broekmans AW, van der Linden IK, Veltkamp JJ, Bertina RM. Prevalence of isolated protein C deficiency in patients with venous thrombotic disease and in the population. Thromb Haemostas 1983; 50: 350
  • 13 Hill RJ, Gordon E. Naturally occurring anticoagulants. Clinical Haemostasis Review 1989; 3: 1-3
  • 14 Briét E, Engesser L, Brommer EJP, Broekmans AW, Bertina RM. Thrombophilia: its causes and a rough estimate of its prevalence. (XIth International Congress on Thrombosis and Haemostasis). Thromb Haemost 1987; 58: 39
  • 15 Malm J, Laurell M, Nilsson IM, Danlbäck B. Thromboembolic disease - Critical evaluation of laboratory investigation. Thromb Haemostas 1992; 68: 7-13
  • 16 British Committee for Standards in Haematology. Guidelines on the investigation and management of thrombophilia. J Clin Pathol 1990; 43: 703-9
  • 17 Clinical Annotation. The hypercoagulable state in clinical practice. Br J Haematol 1991; 79: 148-51
  • 18 Mannuccio PM, Tripodi A. Laboratory screening of inherited thrombotic syndromes. Thromb Haemost 1987; 57: 247-51
  • 19 Roger Edson J, Vogt JM, Huesman DA. Laboratory diagnosis of inherited protein S deficiency. Am J Clin Pathol 1990; 94: 176-86
  • 20 Exner T, Rickard KA, Kronenberg H. A sensitive test demonstrating lupus anticoagulant and its behavioural patterns. Br J Haematol 1978; 40: 143-51
  • 21 Triplett DA, Brandt JT, Kaczor D, Schaeffer J. Laboratory diagnosis of lupus inhibitors: a comparison of the tissue thromboplastin inhibition procedure with a new platelet neutralization procedure. Am J Clin Pathol 1983; 79: 678-82
  • 22 Thiagarajan P, Pengo V, Shapiro SS. The use of the dilute Russell’s viper venom time for the diagnosis of lupus anticoagulants. Blood 1986; 68: 869-74
  • 23 Exner T, Triplett DA, Tabemer D, Machin SJ. SSC Subcommittee for the Standardization of Lupus Anticuagulants. Guidelines for testing and revised cirteria for lupus anticoagulants. Thromb Haemost 1991; 65: 320-2
  • 24 Broekmans AW, van der Linden JK, Jansen-Koeter Y, Bertina RM. Prevalence of protein C (PC) and protein S (PS) deficiency in patients with thrombotic disease. Thromb Res 1986; Suppl VI: 135 (Abstr)
  • 25 Liu HW, Wong KL, Lin CK, Wong WS, Tse PWT, Chan GTC. The reappraisal of dilute tissue thromboplastin inhibition test in the diagnosis of lupus anticoagulant. Br J Haematol 1989; 72: 229-34
  • 26 Hellgren M, Tengborn L, Abildgaard U. Pregnancy in women with congenital antithrombin III deficiency: experience of treatment with heparin and antithrombin. Gynecol Obstet Invest 1982; 14: 127-41
  • 27 Conard J, Horellou MH, Van Dreden P, Lecompte T, Samama M. Thrombosis and pregnancy in congenital deficiencies in AT III, protein C or protein S: study of 78 women. Thromb Haemost 1990; 63: 319-20