Abstract
A strong correlation has been suggested between deep vein thorombosis (DVT) and the presence of an in vitro plasma coagulation inhibitor, named "lupus anticoagulant" (LA). LA is detectable not only in patients with systemic lupus erythematosus (SLE) but also in a number of clinical states. We report a case of recurrent DVT associated with LA after gonadotropin therapy. A 26-year-old woman with infertility underwent a gonadotropin therapy (HMG-HCG) and four months later, DVT of the legs broke out. While this patient had no family history of thorombosis, nor of any other unerlying systemic disorder, blood coagulation tests, revealed prolonged APTT and PT. The reuslts suggested existence of some circulating anticoagulants, and then more specific examinations verified the presence of LA. Since there were no clinical findings of SLE and other disease inducing LA in this patient, it seemed reasonable to conclude that the gonadotropin therapy was an initiating stimulus for production of LA. After that, gonadotropin therapy was repeated two times and recurrence of DVT was observed for each time. This clinical progress indicates that gonadotropin therapy may increase the risk of thorombosis in patients coexisting with LA. We emphasizes that LA should be investigated in all patients with recurrent DVT to determine real cause of vein thorombosis.
