High Lipoprotein (a) Levels Causing Recurrent Deep Vein Thrombosis and Cerebral Venous Sinus Thrombosis in Different Pregnancies: A Case Report

• Published in: Case reports in neurology Vol. 17; no. 1; pp. 107 - 112
• Main Authors: Okada, Akihiro, Kawauchi, Takeshi, Terada, Yukinori, Hashimoto, Kenji
• Format: Journal Article
• Language: English
• Published: Switzerland S. Karger AG 14.07.2025
• Subjects: Single Case – Cerebrovascular Diseases and Stroke; Pregnancy; Cerebral venous sinus thrombosis; Venous thrombosis; Lipoprotein (a)
• ISSN: 1662-680X; 1662-680X
• DOI: 10.1159/000546461

Introduction: High levels of lipoprotein (a) [Lp (a)] have gained attention as a risk factor for venous thrombosis. Venous thrombosis during pregnancy in women without thrombophilic predisposition is attributed to pregnancy itself. Herein, we report a case of high Lp (a) levels manifesting as recurrent deep vein thrombosis (DVT) and cerebral venous sinus thrombosis (CVST) in different pregnancies. Case Presentation: A 29-year-old Nepalese woman developed DVT during her first pregnancy. Examination revealed no thrombophilic predisposition. The thrombus resolved with oral anticoagulant medication, which was discontinued after 3 months. During the second pregnancy, prophylactic subcutaneous heparin injections were initiated to prevent venous embolism. Following several days of non-administration of heparin, she experienced left occipital pain, and magnetic resonance venogram showed left CVST. Oral anticoagulants were initiated, and her headache resolved within a few days. Additional blood tests showed abnormally high levels of Lp (a) at 113 mg/dL. Six months later, the CVST was partially recanalized. Conclusion: If venous thrombosis develops during pregnancy in patients without thrombophilic predisposition, Lp (a) levels should be monitored, and long-term anticoagulant medication may be desirable in those with high Lp (a) levels to prevent recurrence of venous thrombosis.