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Causative genetic mutations for antithrombin deficiency and their clinical background among Japanese patients.

Abstract
We summarize causative genetic mutations for antithrombin (AT) deficiency and their clinical background in Japanese patients. A total of 19 mutations, including seven novel mutations, were identified. We also summarize clinical symptoms of thrombosis, age at onset, family history, and contributing factors for thrombosis, and review the use of prophylactic anticoagulation in pregnant women with heterozygous type II heparin binding site defects (HBS) AT deficiency. The prevalence of thrombosis in probands with type I AT deficiency (88%) was double that observed in those with type II AT deficiency (50%). The prevalence of thrombotic episodes among family members was also higher for type I AT deficiency subjects (82%) than for those with type II AT deficiency (0%). The most common contributing factor for thrombosis among women with type I AT deficiency was pregnancy. Forty-five percent of women with type I AT deficiency developed thrombotic events before the 20th week of gestation. In contrast, women with type II (HBS) AT deficiency appear to be at a lower risk of thrombosis during pregnancy. In conclusion, thrombotic risk varies among different subtypes. Risk assessments based on genetic/clinical backgrounds may contribute to appropriate diagnosis, treatment, and prophylaxis for patients with AT deficiency.
AuthorsAkiko Sekiya, Fumina Taniguchi, Daisuke Yamaguchi, Sayaka Kamijima, Shonosuke Kaneko, Shiori Katsu, Miho Hanamura, Mao Takata, Haruka Nakano, Hidesaku Asakura, Shigeki Ohtake, Eriko Morishita
JournalInternational journal of hematology (Int J Hematol) Vol. 105 Issue 3 Pg. 287-294 (Mar 2017) ISSN: 1865-3774 [Electronic] Japan
PMID27858332 (Publication Type: Journal Article)
Chemical References
  • Antithrombin Proteins
Topics
  • Adolescent
  • Adult
  • Aged
  • Antithrombin Proteins (deficiency, genetics)
  • Asian People
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mutation (physiology)
  • Pregnancy
  • Pregnancy Complications, Cardiovascular (diagnosis)
  • Risk Factors
  • Thrombophilia (complications, diagnosis)
  • Thrombosis (etiology)

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