Familial risks of unusual forms of venous thrombosis: a nationwide epidemiological study in Sweden

Authors


Dr Bengt Zöller, Center for Primary Health Care Research, CRC, Building 28, Floor 11, Entrance 72, Malmö University Hospital, S-205 02 Malmö, Sweden.
(fax: +46 40 391370; e-mail: bengt.zoller@med.lu.se).

Abstract

Zöller B, Li X, Sundquist J, Sundquist K. (Center for Primary Health Care Research, Lund University, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA). Familial risks of unusual forms of venous thrombosis: a nationwide epidemiological study in Sweden. J Intern Med 2011; 270: 158–165.

Abstract.

Objective.  This is the first nationwide study to determine familial risks of unusual forms of venous thrombosis amongst offspring of affected parents and amongst siblings.

Design and settings.  The Swedish Multigeneration Register of 0- to 75-year-old subjects was linked to the Hospital Discharge Register for the period 1987–2007. Standardized incidence ratios (SIRs) were calculated for individuals whose relatives were hospitalized for venous thromboembolism (VTE), as determined by the International Classification of Diseases, compared to those whose relatives were not affected by VTE.

Results.  The total number of hospitalized patients with VTE was 45 362, of which 1824 (4.0%) were affected by a rare thrombotic condition. The familial SIRs in cases with a history of VTE in parents or siblings were significantly increased for migrating thrombophlebitis (1.81; 95% confidence interval (CI) 1.40–2.31), portal vein thrombosis (2.35; 95% CI 1.77–3.06), vena cava thrombosis (1.96; 95% CI 1.42–2.64) and cerebral venous thrombosis (1.74; 95% CI 1.30–2.28). Budd–Chiari syndrome (SIR, 0.92; 95% CI 0.24–2.38) and renal vein thrombosis (SIR, 1.72; 95% CI 0.62–3.77) were not significantly associated with parental or sibling history of VTE; however, these two conditions were very rare, and therefore, we cannot draw any definite conclusions from this finding.

Conclusions.  Family history is an important risk factor for most unusual forms of VTE. Moreover, even the paraneoplastic phenomenon, migrating thrombophlebitis (Trousseau’s syndrome), is associated with a family history of VTE. Thus, our data suggest that most rare forms of VTE have a familial background.

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