Thrombus - 2006


Thrombotic complications of nephrotic syndrome
Elaine C Jolly
pp 1-4
Nephrotic syndrome (NS) is a relatively common renal diagnosis, signifying underlying glomerular disease of various aetiologies. Its relevance to other subspecialties lies in the many complications and sequelae resulting from the marked proteinuria that is part of the syndrome. These include hypogammaglobulinaemia, hypercholesterolaemia and hypercoagulability. It is this last phenomenon, with its implications for increased thrombotic risk, that I will concentrate on in this article. I will discuss the mechanisms leading to the increased procoagulant state, the clinical outcomes (including the increased incidence of thromboembolic events) and finish with an issue that remains unresolved – that of prophylactic anticoagulation in patients with NS.
Comment: JAK2 mutation: a thrombotic risk factor?
Peter Rose
pp 2-2
An acquired point mutation, Val 617 Phe in the exon of JAK2 gene has been described in a substantial proportion of patients with myeloproliferative disorders (MPDs). Initial efforts to date have focused on identifying the mutation across the range of MPDs to see if this correlates with leukaemic transformation or disease progression.
Venous thromboembolism and malignancy
Tina Biss and John Hanley
pp 5-7
There is a well-established link between malignancy and venous thromboembolism (VTE), originally described by Professor Armand Trousseau in 1865.1 In addition to higher rates of VTE in patients with both known and occult malignancy, there is an increased risk of recurrence and complications related to anticoagulation.
IJV thrombosis and ovarian stimulation
Jhansi Mudanna, Shankara Paneesha and Peter Rose
pp 8-8
Internal jugular vein (IJV) thrombosis during controlled ovarian stimulation is not widely recognised. Ovarian hyperstimulation syndrome (OHSS) is a relatively common and potentially serious complication of in vitro fertilisation (IVF) and usually manifests four to five days after harvesting of eggs, with symptoms of transient lower abdominal discomfort, mild nausea, vomiting, diarrhoea and abdominal distension. Thromboembolic disease is an uncommon but serious consequence of (OHSS) and IVF treatment. Upper venous extremities are reported sites for thrombus formation in patients with OHSS.We report a case of late IJV thrombosis in a woman after controlled ovarian stimulation in the absence of inherited thrombophilia.
Warfarin dosing algorithm based on genetic and environmental factors
Farhad Kamali
pp 9-11
Warfarin has long been used as an anticoagulant in the management of deep vein thrombosis, pulmonary embolism, atrial fibrillation and valvular heart disease. Randomised trials1 have more recently demonstrated that anticoagulant therapy can reduce the risk of ischaemic stroke attributable to atrial fibrillation; as such, anticoagulant therapy is now recommended for highrisk patients to prevent stroke.

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