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• W2042414060 abstract "The association between familial protein S deficiency and recurrent venous thrombosis was first described in 1984 and has sometimes been related with arterial thrombosis. Oral contraceptive use is also associated with increased risk of thromboembolism. The combined presence of these two risk factors may increase thrombotic risk. Pabinger et al. conducted a retrospective multicenter study of 34 patients with protein S type-I deficiency and reported no excess thrombotic risk with the use of oral contraceptives. In their report however only total proteins were assessed and no free protein S values were reported even among patients who developed thrombosis after taking oral contraceptives. Thrombosis associated with oral contraceptives and decreased protein S has been reported in three cases. In all low free protein S activity was found. Protein S dysfunction with low activity was reported in one while two others had cerebral sinus thrombosis associated with low free protein S levels on oral anticoagulant therapy. The authors describe the case of a 21-year old woman who took desogestrel 150 mcg and ethinyl-estradiol 30 mcg for six months after which she suffered a femoropopliteal deep-vein thrombosis. She was treated with a continuous intravenous heparin then switched to oral anticoagulation therapy 10 days after starting heparin. Her INR was maintained at approximately 2.1 in the range of 1.9-2.4. Neither the patients parents nor other living family members had a history of thromboembolism. It was determined two and three months after treatment that her protein S was low without anticoagulants. It is therefore concluded that increased venous thrombotic risk may be associated with low free protein S in patients taking oral contraceptives. Moreover oral contraceptive use could diminish the genetically predetermined low levels of protein S among such patients favoring thrombosis. The use of desogestrel and gestodene holds particular risk of venous thromboembolism." @default.
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• W2042414060 date "1996-02-01" @default.
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• W2042414060 title "Third-generation oral contraceptives and low free protein S as a risk for venous thrombosis" @default.
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• W2042414060 doi "https://doi.org/10.1016/s0140-6736(96)90574-7" @default.
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