Four cases of venous thrombosis in athletes with silent hereditary defects of the protein C system

Abstract

We report four cases of athletes, carriers of a defect of the protein C (PC) anticoagulant system, who developed deep vein thrombosis (DVT) after strenuous physical exercise. These cases suggest that there could be a relationship between post-exercise hypercoagulability and the onset of DVT. A retrospective study of cases of DVT associated with hereditary thrombophilia evaluated in our laboratory over a period of about three years (1995–1997) revealed four cases of DVT that occurred in athletes soon after strenuous exercise. The first symptoms of DVT (pain, oedema and cyanosis at variable extent) occurred in the legs of all athletes between 1–3 h after exercise (swimming, rowing or football; see Table 1). Duplex Doppler ultrasound was positive for DVT. Thrombosis was localized in the femoral vein in all subjects except subject 2, in whom it occurred in the popliteal vein. All subjects practised sport at a competitive level, and one was an elite athlete. All were carriers