Portal vein thrombosis while taking a combined oral contraceptive after experienced coronavirus infection

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Resumo

Background: Contraceptives are an important component of women’s reproductive health care, as they not only reduce the number of unwanted pregnancies, but also improve reproductive function. However, oral contraceptives are known to increase the risk of venous thromboembolism. This risk is increased by infection with the COVID-19 virus that predisposes patients to both venous and arterial thrombosis as a result of excessive inflammation, platelet activation, aggravated endothelial dysfunction, and congestive events. If these patients have hereditary thrombophilia, the risk of venous thromboembolism becomes fatal.

Case report: The paper describes a clinical case of a patient with total portal vein thrombosis, who have been taking oral contraceptives for a long time and recovering from the novel coronavirus infection. Studying the blood coagulation system and folate cycle genes, by using PCR, has revealed a gene mutation in the plasminogen activator inhibitor (serpine). The authors demonstrate the data of spiral computed tomography of the abdominal organs, as well as changes in laboratory parameters.

Conclusion: A balanced approach is required when prescribing combined oral contraceptives during the COVID-19 pandemic, especially in women with prothrombotic mutations.

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Sobre autores

Alexey Shklyaev

Izhevsk State Medical Academy, Ministry of Health of Russia

Email: shklyaevaleksey@gmail.com
ORCID ID: 0000-0003-4479-508X

Dr. Med. Sci., Professor, Professor at the Department of Faculty Therapy with courses of endocrinology and hematology

Rússia, Izhevsk

Alina Fatkhieva

Izhevsk State Medical Academy, Ministry of Health of Russia

Autor responsável pela correspondência
Email: alifathi98@mail.ru

student

Rússia, Izhevsk

Alexey Bessonov

First Republican Clinical Hospital, Ministry of Health of the Udmurt Republic

Email: besson_alex@mail.ru

PhD, Head of the Gastroenterology Department

Rússia, Izhevsk

Maria Meleshkina

First Republican Clinical Hospital, Ministry of Health of the Udmurt Republic

Email: alifathi98@mail.ru

gastroenterologist

Rússia, Izhevsk

Sergey Zykov

First Republican Clinical Hospital, Ministry of Health of the Udmurt Republic

Email: sergeyzykov1977@gmail.com

radiologist

Rússia, Izhevsk

Bibliografia

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  3. Gialeraki A., Valsami S., Pittaras T., Panayiotakopoulos G., Politou M. Oral contraceptives and HRT risk of thrombosis. Clin. Appl. Thromb. Hemost. 2018; 24(2): 217-25. https://dx.doi.org/10.1177/1076029616683802.
  4. Dragoman M.V., Tepper N.K., Fu R., Curtis K.M., Chou R., Gaffield M.E. A systematic review and meta-analysis of venous thrombosis risk among users of combined oral contraception. Int. J. Gynaecol. Obstet. 2018; 141(3): 287-94. https://dx.doi.org/10.1002/ijgo.12455.
  5. Kazantsev A.N. Thrombectomy vs conservative therapy in patients with COVID-19. Cardiovascular Therapy and Prevention. 2021; 20(4): 2931. (in Russian). https://dx.doi.org/10.15829/1728-8800-2021-2931.
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  8. Markelov M.I., Beznoschenko O.S., Ivanets T.Yu., Pyregov A.V., Esayan R.M., Gavrilova T.Yu., Krechetova L.B. Features of the plasma hemostasis system in patients with the novel coronavirus infection COVID-19. Obstetrics and Gynecology. 2020; (9): 138-44. (in Russian). https://dx.doi.org/10.18565/ aig.2020.9.138-144.
  9. Limanova O.A., Gromova O.A., Fedotova L.E. Combined oral contraception and treatment of new coronavirus infection (COVID-19): drug interaction issues. Pharmacokinetics and Pharmacodynamics. 2020; (3): 30-9. (in Russian). https://dx.doi.org/10.37489/2587-7836-2020-3-30-39.
  10. Kow C.S., Mustafa Z.U., Hasan S.S. The use of combined hormonal contraceptives amid the COVID-19 pandemic. Eur. J. Contracept. Reprod. Health Care. 2021; 26(1): 85-6. https://dx.doi.org/10.1080/13625187.2020.1849618.
  11. Shklyaev A.E., Fatkhieva A.R., Bessonov A.G., Zykov S.Yu., Malakhova I.G. Liver cirrhosis due to thrombosis of the portal, superior mesenteric and splenic veins: a five-year dynamics. Medical News of North Caucasus. 2021; 16(4): 427-9. (in Russian). https://dx.doi.org/10.14300/mnnc.2021.16104.
  12. Shklyaev A.E., Bessonov A.G., Chushyalova D.A., Mikhailova M.D., Meleshkina M.V. Features of the course of coronovirus infection against the background of pseudomembranous colitis in the early postpartum period: clinical observation. Obstetrics and Gynecology. 2021; (9): 232-6. (in Russian). https://dx.doi.org/10.18565/aig.2021.9.232-236.

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2. Figure 1. CT scan of the abdominal organs with contrast. Thrombosis of the main trunk of the portal vein throughout

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3. Figure 2. CT scan of the abdominal organs with contrast. Development of collateral venous blood flow in the hilum of the liver.

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