ニンシン オ ケイキ ニ ジョウミャク ケッセンショウ オ ハッショウシ センテンセイ アンチトロンビンIII ケッソンショウ ト シンダン サレタ イチレイ

Congenital antithrombin III (AT III) deficiency is an inherited autosomal dominant disorder. Patients often suffer from recurrent venous thromboses that are triggered by several occasions (operation, gestation, trauma, oral contraceptive drug etc.). Moreover, 60% of them are said to be associated with pulmonary embolism. The patient of this report is 27-year-old pregnant woman in the first trimester. She felt pain in the back of her head and left auricle and presented with dyslexia and aphasia in late of March, 20XX. Getting CT brain scan, MRI brain scan, and blood sampling at the nearby hospital, she was suspected of having thrombosis of left sigmoid and transverse sinus due to AT III deficiency. Because she wanted to give birth to her first child without termination, she was referred to our hospital. We used heparin as the anticoagulant therapy because warfarin had the risk of teratogenesis. But in condition of low serum level of AT III activity, it didn’t work effectively. So we also did frequent complement of AT III. Strict anticoagulant therapy resulted in better outcome for both the patient and her baby without fatal venous thromboses or fetal complications