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Case Reports
. 2023 Jul 28;17(1):323.
doi: 10.1186/s13256-023-04038-1.

Acquired SERPINC1/antithrombin deficiency during oral contraceptive consumption: a case report

D Denora  1 , M V Di Rosa  2 , N Altamura  2 , F Pellicori  2 , P Vinci  2 , U G Sisto  3 , F Spanò  2 , F G Di Girolamo  4 , N Fiotti  2 , G Biolo  2
Affiliations
Case Reports

Acquired SERPINC1/antithrombin deficiency during oral contraceptive consumption: a case report

D Denora et al. J Med Case Rep. .

Abstract

Background: SERPINC1 is a glycoprotein that regulates blood coagulation. SERPINC1 congenital or acquired deficiencies represent a significant risk factor for thromboembolic disease. SERPINC1 acquired defects are observed in very few cases and can occur in many clinical conditions such as treatment with L-asparaginase or oral contraceptive (particularly estrogen derivatives), but these conditions are not routinely investigated.

Case presentation: A 50-year-old Caucasian woman who took gestodene 75 µg/ethinylestradiol 20 µg as oral contraceptive, was sent to our thrombophilia clinic because, on thrombophilia testing, a reduction of SERPINC1 (74%) and a slight increase in circulating D-dimer and homocysteine were found. We investigated triggers of such SERPINC1 reduction, and identified gestodene 75 µg/ethinylestradiol 20 µg use as the most likely candidate. Two months after the discontinuation of the oral contraceptive, SERPINC1 value returned to normal (92%) and D-dimer and homocysteine were normalized.

Conclusion: Each patient has a different sensitivity to contraceptive use. Genetic (or epigenetic) regulation of anticoagulant proteins might account for a different rate of consumption of anticoagulant proteins as oral contraceptives and probably determine the susceptibility to thrombotic events.

Keywords: Acquired SERPINC1; Antithrombin deficiency; Case report; D-dimer; Oral contraceptives; Thrombophilia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Time course of homocysteine, D-dimer, and SERPINC1 during observation
See this image and copyright information in PMC

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